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American-Pakistani physician Dr. Samad Khan has agreed to pay $3.5 million to the United States to settle allegations under the False Claims Act in the Eastern District of Texas, as announced by Acting U.S. Attorney Jay R. Combs on Friday.
According to the Department of Justice, Dr. Samad, a medical doctor, has consented to this payment to settle claims that he knowingly submitted or facilitated the submission of fraudulent claims that were not fulfilled.
From approximately May 2020 to April 2022, the Uninsured Program reimbursed eligible healthcare providers for COVID-19 tests, related items and services, treatments, and vaccines provided to uninsured individuals.
Dr. Samad owns SK Primary Care, PLLC, a medical clinic located in Frisco, Texas. During the COVID-19 Public Health Emergency (PHE), SK Primary Care offered healthcare services that included specimen collection for COVID-19 testing.
The recent settlement addresses accusations that between April 2020 and October 2021, Dr. Samad knowingly submitted or caused the submission of false claims to the Uninsured Program, billing for evaluation and management services (E/M Services) that were never rendered.
The U.S. government claims that throughout the PHE, SK Primary Care operated numerous COVID-19 testing locations across Texas, most of which were walk-up or drive-through sites.
Patients could sign up for testing at these sites through the website “GoGetTested.Com.”
The government alleges that medical assistants staffed the COVID-19 testing sites, conducting specimen collection via nasal swabs for the tests.
Dr. Samad was aware that the correct CPT codes for the services offered at these sites were for specimen collection. However, he instead submitted claims using CPT codes for higher-level E/M services.
The U.S. asserts that patients who visited these testing sites were never seen by Dr. Samad or any qualified healthcare provider (QHP), and there were no E/M services provided to patients either in person or through audiovisual means.
During the period between April 2020 and October 2021, Dr. Samad allegedly submitted around 400,000 claims for higher-level E/M services to the Uninsured Program, most of which were categorized as level 2 and level 3 services.
Furthermore, it is claimed that Dr. Samad and the management company of SK Primary Care intentionally misclassified the specimen collection services as higher-level E/M services, allowing for significantly higher reimbursement rates.
Additionally, in coordination with the clinic’s management company, Dr. Samad and SK Primary Care often submitted two claims for E/M services related to COVID-19 tests—one for the initial test and another for communicating results.
However, the second claim for results was typically handled by an employee or contractor, like nurse practitioners or medical assistants. They would convey results through a scripted courtesy call, often without having any audiovisual interaction with the patients. In many cases, results were merely emailed or texted to patients.
As a consequence of the fraudulent claims for E/M services that were not performed, Dr. Samad received payments from the Uninsured Program that he was not entitled to.
Jay R. Combs, Acting U.S. Attorney for the Eastern District of Texas, noted, “The COVID-19 pandemic required increased trust in frontline healthcare providers. Unfortunately, some of these providers exploited that trust, profiting unethically during a crisis, and the Eastern District of Texas will hold them accountable.”
Jason E. Meadows, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), emphasized that false claims undermine public trust and misallocate taxpayer resources.
“This settlement underscores our commitment to protecting taxpayer funds and collaborating with law enforcement to hold accountable those who exploit the American public,” Meadows remarked.
The resolution was achieved through a coordinated effort involving the Justice Department’s Civil Division, Fraud Section, and the U.S. Attorney’s Office for the Eastern District of Texas, along with assistance from HHS-OIG.
A senior American-Pakistani doctor in Florida, who is affiliated with APPNA, explained that Dr. Samad is of Pakistani heritage. Another American-Pakistani physician in Texas expressed that Dr. Samad should be considered innocent, stating that there are various factors that could justify the incurred amount.
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