Dr Samad Khan settles $3.5m false claims allegations in USA

American-Pakistani Dr Samad Khan has agreed to pay the United States $3.5 million to resolve False Claims Act allegations in the Eastern District of Texas, Acting US Attorney Jay R Combs announced on Friday.

According to the Justice Department, Samad, MD, has agreed to pay the amount to resolve allegations that he violated the False Claims Act by knowingly submitting or causing the submission of false claims that were not performed.

Between approximately May 2020 and April 2022, the Uninsured Program reimbursed eligible providers for Covid-19 tests, testing-related items and services, treatment, and vaccines performed on uninsured individuals.

Samad is a physician who owns SK Primary Care, PLLC, a medical clinic in Frisco. During the Covid-19 Public Health Emergency (“PHE”), SK Primary Care provided healthcare services, including specimen collection for Covid-19 tests.

The settlement announced on Friday resolves allegations that from April 2020 through October 2021, Samad knowingly submitted or caused the submission of false claims to the Uninsured Program by billing evaluation and management services (E/M Services) that were not performed.

The United States contends that during the PHE, SK Primary Care provided services at dozens of Covid-19 testing sites in Texas, operated by SK Primary Care and its management company, the majority of which were walk up or drive-through testing sites (the “Covid test sites”).

Patients could register to receive a test at the Covid test sites by registering online through a website called “GoGetTested.Com.”

The United States alleges that the Covid test sites were staffed with medical assistants who performed specimen collection services through nasal swabs on patients for Covid-19 tests.

Samad knew that the appropriate CPT Codes for the services provided at the Covid test sites were specimen collection codes, including CPT Code 99211, but instead submitted claims under CPT Codes for Higher Level E/M Services.

The United States contends that patients who went to the Covid test sites were never seen by Samad or any other QHP, and at no time was Samad or any other QHP providing any E/M Services to patients at the COVID test sites either in person or by audiovisual means.

From April 2020 through October 2021, for the services provided at the Covid test sites, Samad submitted or caused the submission of approximately 400,000 claims by SK Primary Care to the Uninsured Program for Higher Level E/M Services, the majority of which were level 2 and 3 E/M services.

The United States further alleges that Samad, in conjunction with and at the direction of SK Primary Care’s management company, coded the Covid specimen collection services as Higher Level E/M Services.

Reimbursements for E/M Services were substantially higher than reimbursements for specimen collection.

Moreover, in conjunction with and at the direction of SK Primary Care’s management company, SK Primary Care and Samad often submitted two claims for E/M Services for Covid-19 test specimen collection—the first “encounter” for the test, and a second “encounter” for providing results.

The second “encounter” of providing results was not Samad providing E/M Services. Instead, an employee or contractor of SK Primary Care or SK Primary Care’s management company, such as nurse practitioners (NPs) and medical assistants, would provide tests results via telephone based on a courtesy call script.

NPs were not providing medical services, did not have any audiovisual connection to patients, and in many instances never even spoke to the patients to provide results, which were emailed or sent by text message.

As a result of these false claims for payment for E/M Services that were not performed, Samad received payments from the Uninsured Program to which he was not entitled.

“The onset of the Covid-19 pandemic required both beneficiaries and the government to place their trust in front-line healthcare providers, even more than usual,” said Jay R Combs, Acting US Attorney for the Eastern District of Texas.

“Unfortunately, some of those providers abused that trust and instead took advantage of the crisis to artificially inflate profits. It is these individuals that the Eastern District of Texas will hold accountable for their greed,” said Combs

“When health care professionals receive payments for false claims they submit to federal health care programs, they erode public trust and divert taxpayer-funded resources away from those who truly need them,” said Special Agent in Charge Jason E Meadows of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG).

“This settlement demonstrates our steadfast commitment to safeguarding taxpayer funds and working with our law enforcement partners to use all tools in our arsenal to hold accountable those who steal from the American public,” remarked Meadows.

The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and the US Attorney’s Office for the Eastern District of Texas with assistance from HHS-OIG.

A senior American-Pakistani doctor based in Florida, who is also associated with APPNA, told this scribe that Dr Samad is of Pakistani descent.

Another American Pakistani doctor based in Texas said that Dr Samad should be considered innocent as he was not legally liable to pay. He was of the view that a number of reasons can be cited for the amount incurred on Dr Samad.