WASHINGTON, D.C. – Empower Oversight today filed a whistleblower referral with the Inspector General of the U.S. Department of Health and Human Services on behalf of Natasha Steward, a Medical Case Manager at the AIDS Task Force of the Upper Ohio Valley, Inc. (ATFUOV), a nonprofit AIDS service organization based in Wheeling, WV. The referral describes conduct that may constitute violations of federal fraud and false claims laws, anti-kickback statutes, HIPAA privacy requirements, and other federal rules governing the Ryan White HIV/AIDS Program.
West Virginia received approximately $5 million in federal Ryan White Part B funds in fiscal year 2025, administered through the state’s Department of Health and contracted in part to ATFUOV. Those funds are intended to provide HIV health care and medications to low-income individuals with HIV.
The whistleblower began working as a Medical Case Manager for ATFUOV in April 2026. In the course of processing an inactive client list of nearly 200 files, she identified a series of troubling irregularities, including benefit disbursements continuing to clients she knew to be deceased.
“When Ms. Steward raised her concerns internally, she was told it was ‘part of what we are cleaning up’ and was illegally instructed to keep the matter inside the organization,” said Tristan Leavitt, president of Empower Oversight. “When she attempted to blow the whistle to state officials, she was told to take her disclosures back to the very supervisor she had identified as potentially complicit. That is exactly the kind of breakdown in accountability that demands independent federal review, especially as it relates to protecting public taxpayer dollars.”
The referral documents show multiple instances of questionable conduct:
Disbursements to deceased beneficiaries. Records show federal benefits, including food and gas cards, continuing to two clients after their documented deaths, in one case for nearly three years and in another for more than two years.
Unverified or fictitious enrollees. Many client files contain no proof of identity, income, or HIV status.
Improper billing and potential “payer of last resort” violations. Instances of the AIDS Drug Assistance Program being billed ahead of clients’ existing insurance coverage, including Medicaid, Medicare Part D, and TRICARE, rather than serving as the payer of last resort it is required to be. In some instances, the program and a client’s other coverage may have been billed for the same medications — resulting in false claims against multiple federal programs.
Potential kickbacks. Ryan White Part B clients could “put anything you want on the Ryan White Part B tab.” The pharmacy historically submitted monthly bills paid from grant funds, raising potential violations of federal anti-kickback statutes.
Misappropriation of program property and alleged embezzlement. Program gas cards and credit cards were used for personal purchases. A departing employee took gas cards upon separation. A supervisor at ATFUOV told Ms. Steward that she knew a predecessor case manager had been embezzling program funds, but that her own supervisor had refused to act on that information.
Retention of system access by departed employees. Two former employees retained access to CAREWare and patient data for weeks after leaving the program, in apparent violation of HIPAA security requirements.
Falsification of records. Entries in the federal CAREWare data system appeared under Steward’s name despite predating her employment, then were changed following Steward’s initial report of concerns.
Suppression of reporting. Supervisor instructed employee her to keep concerns internal and directed staff in written meeting minutes to “keep our house stuff in-house” and to refrain from contacting the state’s Division of STD and HIV with complaints about the organization.
In its request for an investigation, Empower Oversight is calling for the IG to obtain and audit complete program records; reconcile billing against third-party coverage; coordinate with Health and Human Services program integrity and the Department of Justice as warranted; preserve the audit trail given the record alteration concerns; and take steps to protect the whistleblower from retaliation.
This filing is the latest in Empower Oversight’s ongoing, multi-state investigation into the misuse of federal funds. The organization has already filed similar requests:
- Empower Oversight pressed the California Department of Public Health for comprehensive records related to hospice fraud and oversight failures, focusing on how the agency responded, or failed to respond, to known fraud indicators, including suspicious clustering of hospice providers at single addresses, abnormal billing patterns, and unusually high reimbursement rates.
- In January 2026, Empower Oversight filed a records request with the Minnesota Department of Children, Youth, and Families targeting that state’s Child Care Assistance Program (CCAP), which receives approximately $185 million in federal funds annually. Minnesota was among five states subject to a federal funding freeze and has faced sustained scrutiny over empty childcare facilities and improper payments identified by federal inspectors.
- Empower Oversight filed a Freedom of Information Law request with the New York State Office of Children and Family Services, seeking records related to the oversight and integrity of New York’s own CCAP, a program that distributed more than $1.1 billion in federal funds in fiscal year 2025.
- Empower Oversight filed a public records request with New York’s Center for Hospice and Palliative Care, the state agency responsible for regulating the hospice industry, seeking documents that shed light on potential systemic failures in hospice oversight, and on how the agency has identified, responded to, or declined to act on known fraud indicators. The letter can be found here.
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