SAN ANTONIO – United States Attorney Justin R. Simmons announced criminal charges against Christina Charles, 52, in connection with an alleged scheme to defraud Medicare. The charges filed in federal court are part of the Department of Justice’s 2026 National Health Care Fraud Takedown. Charles is charged by indictment with conspiracy to defraud the United States and to solicit and receive health care kickbacks in connection with a hospice fraud scheme.
As alleged in the indictment, Charles received illegal kickbacks in return for referring patients to multiple San Antonio area hospice companies. Based on those referrals, Charles caused the submission of over $9 million in claims for hospice services that were procured through illegal kickbacks and bribes and ineligible for Medicare reimbursement. Medicare paid approximately $3 million based on those claims. The case is being prosecuted by Assistant U.S.
Attorney Justin Chung of the Western District of Texas.“Americans place a lot of trust in their healthcare providers,” said U.S. Attorney Simmons. “When those in the healthcare field engage in fraudulent conduct, it erodes that trust. Here in the Western District of Texas, we have and will continue to hold providers accountable, both civilly and criminally, when they attempt to defraud federal healthcare programs and steal from the American taxpayer.”The charges announced by U.S.
Attorney Simmons are part of a strategically coordinated, nationwide law enforcement action that resulted in charges against 455 defendants, including 90 doctors and other licensed medical professionals, for their alleged participation in health care fraud and opioid abuse schemes involving over $6.5 billion in false claims and significant patient harm, including death. The Takedown represents a new era in federal, state, and international cooperation to combat health care fraud: cases in 56 federal districts and 45 U.S. states and territories, with 50 state Medicaid Fraud Control Units participating, the most in Department history. In addition, unprecedented international cooperation over the two-week Takedown resulted in the apprehension and return to the United States of the following health care fraudsters: one defendant in Kyrenia in connection with an over $3.7 billion scheme; two defendants in Estonia in connection with a previously charged $10.6 billion scheme; and, in the Philippines, one of FBI’s Most Wanted Fraudsters in connection with a previously-charged $1.2 billion telemedicine fraud scheme. The Takedown involved the cutting-edge use of data analytics to target the worst actors; the seizure of over $182 million in cash, luxury vehicles, jewelry, and other assets; and full-spectrum accountability for all criminal actors from doctor’s offices to corporate boardrooms.
This coordinated enforcement action involves a whole-of-government approach, including: Actions by the Centers for Medicare and Medicaid Services (CMS) to suspend 1,079 providers and revoke billing privileges for 1,403 providers.48 Civil Monetary Payment settlements amounting to over $73 million, over 1,400 provider exclusions, and 25 actions by the U.S. Department of Health and Human Services, Office of Inspector General (“HHS-OIG”) under the Civil Monetary Penalties Law seeking more than $10 billion in payments to the Medicare Trust Fund from payments that CMS caught and suspended before the funds were paid to the fraudulent providers.Civil charges against 13 defendants for $14.8 million in health care fraud schemes, as well as civil settlements with 31 defendants totaling $23 million.928 administrative cases by the Drug Enforcement Administration (DEA) seeking the revocation of authority to handle and/or prescribe controlled substances since October 1, 2025.Also, as part of the Department of Justice’s 2026 National Health Care Fraud Takedown, Ellen B. Duncan, M.D., of Boerne, and her practice entity, Ellen Boyle Duncan, PLLC d/b/a Duncan Medical Group, located in San Antonio, reached a civil settlement in the amount of $3,440,538.65 to resolve allegations that Dr. Duncan: (i) caused the submission of claims to Medicare and TRICARE for injections of Fluid Flow, aka Fluid GF, an amniotic-based product that is considered an experimental, unapproved biologic; and (ii) upon being later informed this product was not eligible for reimbursement, took steps to avoid repayment of the reimbursements.
The case was settled by Assistant U.S. Attorney Erin M. Van De Walle of the Affirmative Civil Enforcement Unit for the Western District of Texas.In Killeen, Trevor’s Place LLC, an applied behavioral analysis clinic located in Killeen, Texas, agreed to entry of a $430,280.79 civil consent judgment to resolve allegations the company submitted inflated claims for reimbursement to the TRICARE program by misrepresenting and billing for services not provided. The case was settled by Assistant U.S.
Attorney Thomas Parnham for the Western District of Texas.Descriptions of each case from Districts across the country involved in the Health Care Fraud enforcement action are available on the Department’s website here.An indictment, information, or complaint is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.The claims resolved by the settlement are allegations only, and there has been no determination of liability.###