“All About the CLIA”: What the $100M COVID-Test Fraud Indictment Means for Health Care Executives

On October 8, 2026, a federal grand jury in Maryland returned a 13-count indictment against Marc Aaron Potash, the founder and chief executive of Tiero, LLC, a Gaithersburg company. The case, United States v. Potash, No. 8:26-cr-00353 (D. Md.), was unsealed the next day. It charges one count of conspiracy to commit health care fraud, seven counts of health care fraud, and five counts of conducting monetary transactions in criminally derived property.

The government’s theory is easy to state. According to the indictment, Tiero obtained a laboratory certificate by telling Maryland regulators it tested patients on site, then used that certificate to bill insurers for laboratory testing when it was only mailing over-the-counter home test kits. The U.S. Attorney’s Office for the District of Maryland says the scheme produced more than $100 million in claims and more than $50 million in payments.

The details are what matter to anyone who runs a lab, a clinic, a diagnostics company, or a billing operation. This case shows how prosecutors build a health care fraud case out of ordinary business records: a regulatory application, a claim form, a reply to an insurer audit, and the executive’s own text messages.

An indictment is an accusation, not proof. Mr. Potash is presumed innocent, and this post analyzes only the public charging document.

What the indictment alleges

The indictment describes Tiero as a Delaware company owned by a venture firm, URock, LLC, of which Mr. Potash was the founder and managing partner. From about January 2022 through May 2026, the grand jury alleges, Tiero billed Medicare, Medicaid, the Federal Employees Health Benefits Program, and commercial insurers under CPT code 87426, the laboratory code for a SARS-CoV-2 antigen test, with modifier QW (a CLIA-waived test) and place-of-service code 11 (a physician’s office).

According to the indictment, those claims represented that a provider at Tiero administered or analyzed each test on a particular date. The government alleges that none of that was true. Tiero allegedly shipped home test kits to insured people across the country, as a practice only after the insurer had already paid, and listed a Michigan physician as the rendering provider for patients who had never visited the office.

The certificate was the business model

The centerpiece of the case is a Clinical Laboratory Improvement Amendments (CLIA) certificate. The indictment explains that laboratories generally need CLIA certification to be paid by insurers and federal programs. It quotes Mr. Potash as saying Tiero’s business model was “All about the CLIA.”

The government then lays out the application in detail. On January 28, 2022, the indictment alleges, Mr. Potash emailed the Maryland Department of Health that Tiero was seeking a waiver for tests “conducted in the office,” and the same day texted another individual:

“We need the clia only for in office testing / It doesn’t matter how we get it / They will grant it for that / Don’t discuss test distribution with Maryland”

The indictment goes on to allege a February 2022 letter requesting a waiver “to perform [point-of-care] tests in our office,” a June 2022 email stating “Yes, we do test on site,” participation in a July 2022 state on-site audit, and a laboratory protocol handbook prepared for the regulator. In September 2022, recruiting a lab director, Mr. Potash allegedly wrote: “We won’t be doing any tests . . . it’s just to keep the clia.”

The lesson reaches well beyond COVID testing. Statements to a state licensing agency or an accreditation body are not paperwork that sits in a drawer. When a federal case is built, they become the government’s first exhibits, because they show what the company said it was doing and when. A misstatement to a federal agency can also be charged on its own under 18 U.S.C. § 1001.

Every field on a claim form is a representation

Counts two through eight are worth reading closely. Each charges a single claim, and the amounts billed are $102 or $272. The government did not need large individual claims. Under 18 U.S.C. § 1347, each execution of a scheme to defraud a health care benefit program is its own offense, punishable by up to 10 years.

The indictment treats every element of a claim as a statement of fact: the procedure code, the modifier, the place of service, the date of service, and the rendering provider. Billing disputes that look technical, such as which code fits a product shipped to a patient, become criminal when the government can show the company knew the answer and billed anyway. Here the indictment alleges that in May 2022, after being alerted that 87426 was not the correct code for distributing home tests, Mr. Potash texted the person who raised it that he would be sending “a bunch of push back” and added, “You should discuss this with me before sending an email like that.”

Two other allegations show how prosecutors frame concealment. The indictment says claims were spread across three service dates a month to get around an insurer’s daily system edit, and that when commercial insurers audited Tiero, invoices with false service dates were created in response. An audit is often the point where a civil billing problem turns into a criminal one. What a company produces to an auditor, and who prepares it, deserves the same care as a response to a subpoena.

The intent case is written in the defendant’s own words

Health care fraud requires proof that the defendant acted “knowingly and willfully.” Section 1347(b) adds that the government does not have to prove the defendant knew of the statute itself or specifically intended to violate it.

In this indictment, the government’s proof of intent comes largely from the defendant’s messages, as alleged: “It doesn’t matter how we get it.” “We won’t be doing any tests.” An employee’s 2022 email warning that patients and insurers were telling the listed physician they “do not remember rendering service/did not render service.” A July 2024 discussion about increasing Tiero’s insurance coverage for “criminal litigation.” And an August 2025 WhatsApp message that he was “almost thrown in jail for insurance fraud.”

Whatever the defense makes of those statements at trial, the drafting choice is telling. Prosecutors quote text and WhatsApp messages because jurors understand them instantly. Executives should assume that every business message on every platform, including encrypted apps, will one day be read aloud in a courtroom.

Spending the money is a separate crime

Counts nine through thirteen charge violations of 18 U.S.C. § 1957, which makes it a crime to knowingly engage in a monetary transaction of more than $10,000 in property derived from specified unlawful activity. The government does not have to prove any attempt to hide the money. The transaction itself is the offense, with a maximum of 10 years per count.

The charged transactions are a wire of about $118,000 for a Range Rover, about $4.1 million from a farm LLC to buy property in Beallsville, Maryland, about $100,000 for a Mercedes-Benz, and two sets of securities transfers, about $4.26 million and about $8.97 million, between Morgan Stanley investment accounts in January 2024. Those last two counts stand out. They charge moves of securities between brokerage accounts, which shows how broadly the government reads “monetary transaction” when the underlying funds are alleged to be fraud proceeds.

The forfeiture allegation seeks the two vehicles, the Beallsville property, and all funds in a Morgan Stanley account that held about $20.4 million as of July 31, 2026, along with substitute assets. Health care fraud forfeiture under 18 U.S.C. § 982(a)(7) reaches property derived from “gross proceeds,” not net profit. When the government moves to restrain assets early, it affects a defendant’s ability to fund a defense. Section 1957 itself excludes any transaction “necessary to preserve a person’s right to representation as guaranteed by the sixth amendment,” and protecting the ability to retain counsel is an issue to raise at the very start of a case like this.

The enforcement backdrop

The U.S. Attorney’s Office describes the case as part of the administration’s Task Force to Eliminate Fraud and points to the Justice Department’s National Fraud Enforcement Division, announced April 7. The investigating agencies were the FBI, the HHS Office of Inspector General, and the Office of Personnel Management’s Office of Inspector General, which oversees the federal employee health plan.

That combination tells a story. Pandemic-era billing to federal programs, federal employee health plans, and commercial insurers is being examined together, and conduct dating to 2022 is being charged in 2026. Earlier posts on this blog cover DOJ’s fraud priorities and national health care fraud takedowns. This indictment shows the same approach applied to a single company and its founder.

What health care executives should take from this case

• Regulatory filings are evidence. CLIA applications, accreditation surveys, and enrollment forms should match how the business actually operates, and they should be updated when the model changes.
• Coding is a statement of fact. When someone inside the company questions a code, the response should be documented, reviewed by qualified billing and legal advisers, and corrected if needed.
• Complaints are warnings. Patients or payers saying a service was never rendered is the moment to stop and review, not to explain the process to the provider.
• Audit responses carry risk. Documents created for an auditor should never be reconstructed or backdated. Counsel should be involved before anything is produced.
• Messages last forever. Casual texts about regulators, insurers, or “jail” will be read in context by a jury.
• Asset moves draw scrutiny. Large purchases and transfers of money tied to disputed billings can become separate felony counts.

Anyone facing an insurer audit, an HHS-OIG or FBI inquiry, or a grand jury subpoena tied to billing should speak with experienced health care fraud defense counsel before responding. Early decisions, such as whether to produce documents voluntarily, whether employees should sit for interviews, and whether a proffer makes sense, often shape the case more than anything that happens later. Conspiracy charges under § 1349 carry the same penalties as the underlying offense, so the scope of a case can expand quickly once a company’s billing practices are under review.

Attorney Vikas Bajaj is admitted in California (2001) and Texas (2022) and appears in federal courts nationwide where admitted. For more on how the Law Office of Vikas Bajaj, APC approaches these matters, see our pages on Medicare fraud defense, white-collar defense, and federal criminal defense, or browse the Legal Blog.

Disclaimer

This post is for general informational purposes only. It is not legal advice and does not create an attorney-client relationship. It discusses allegations in a public indictment; Mr. Potash is presumed innocent unless and until proven guilty. Federal criminal cases turn on specific facts and controlling law, which can differ by circuit. Consult qualified counsel about any investigation, audit, subpoena, or forfeiture matter.

Sources

1. United States v. Potash, No. 8:26-cr-00353-PX (D. Md.), docket on CourtListener, including the sealing and unsealing orders (ECF 3 and 6).
2. ECF 1, Indictment, filed Oct. 8, 2026, unsealed Oct. 9, 2026 (15 pages), PDF.
3. U.S. Attorney’s Office, District of Maryland, “Maryland Man Facing Federal Indictment for Role in COVID-19 Healthcare Fraud Scheme Totaling More Than $100M,” Oct. 9, 2026 (office home page).
4. 18 U.S.C. § 1347, 18 U.S.C. § 1349, 18 U.S.C. § 1957, 18 U.S.C. § 982, and 18 U.S.C. § 1001.
5. Background reporting: CBS Baltimore (Oct. 9, 2026), WTOP (Oct. 11, 2026), and Becker’s Hospital Review.

Photo: COVID-19 rapid antigen test kit, by dronepicr, licensed under CC BY 2.0 (resized), via Wikimedia Commons.