The fight to fund medically needy communities never ends in America. The battle has been going on long before the existence of the chaos-makers at the Department of Government Efficiency (DOGE). It plays out in every county in Nevada, in urban and rural communities alike, and every dollar counts.

For proof, look no further than the FBI’s yearslong investigation of Silver State Health Services. Federal authorities now allege insiders at Silver State, formerly a federally qualified community health center operator based in Las Vegas, served themselves by diverting millions in grants earmarked to help the poor and underserved.

In a 13-count superseding indictment unsealed May 13 in U.S. District Court, Rick Kiran Saga joined previously indicted Silver State Chief Executive Officer David Ryan Linden as defendants in a case that alleges federal program theft, conspiracy, money laundering and filing false documents. The indictment also includes two forfeiture actions. 

Two money laundering counts list transactions totaling nearly $1.8 million. Two other felony money transaction counts show wire transfers from two local title companies totaling nearly $3.6 million. The criminal forfeiture component lists property worth at least $2.1 million.

Presented to the federal grand jury by Assistant U.S. Attorneys Steve Myhre and Justin Washburn, the superseding indictment portrays Saga as an integral part of the scam. In a Monday afternoon detention hearing in Las Vegas before U.S. Magistrate Judge Daniel J. Albregts, Saga was represented by attorney David Brown and released on a personal recognizance bond.

The defendants’ names may ring familiar. I’ve been reporting on the strange goings on at Silver State in Las Vegas and Pahrump for several years. The FBI investigation resulted in the June 2024 indictment of Linden in a criminal action involving a $735,000 U.S. Health Resources and Services Administration (HRSA) grant designed to pay personnel costs to serve indigent patients. The dollars flowed through Silver State Services into a bank account held by Freedom Infusions LLC, where it was, as the U.S. attorney’s office put it, “used for the benefit of others.”

The addition of Saga to the indictment not only adds an elusive defendant, but a splash of intrigue as well. According to multiple sources close to the case, Saga had access to large sums of cash and wasn’t shy about making cash campaign contributions and meeting with elected officials and one of their well-connected lobbyist-advisers at the former home of the late casino magnate Bill Bennett.

Saga was also a presence in Nye County, where he obtained a marijuana license and was part of a group that lobbied to acquire the shuttered Pahrump Medical Center with the help of now-former Nye County Commissioner Leo Blundo.

The federal funds were obtained through HRSA, an agency responsible for transferring health care benefits and services to areas of need. With a physician shortage and more than 800,000 residents on Medicaid, there are plenty of places needing service.

Silver State federal grant funds were intended to pay salaries and benefits for the health care providers they employed. They were also required to submit truthful financial statements explaining how the money was spent, according to the indictment.

Instead, authorities say, beginning in June 2019, the funds were funneled through multiple limited liability corporations and later used to purchase multiple pieces of real estate. The defendants “converted, misappropriated, embezzled and stole” from Silver State’s accounts and attempted to cover the theft by making false entries into Silver State’s books and sending false financial statements to HRSA.

Fraud related to federal health care programs is nothing new. In 2023 alone, the U.S. Department of Justice reported $2 billion in fraudulent activity settlements with major corporations such as the Cigna Group agreeing to pay $172 million to resolve allegations it used untruthful diagnosis codes for some of its Medicare Advantage clients.

Set against the largest cases, the Silver State indictment might appear small — until you consider the needy medical patients that money was designated to serve.

John L. Smith is an author and longtime columnist. He was born in Henderson and his family’s Nevada roots go back to 1881. His stories have appeared in New Lines, Time, Readers Digest, Rolling Stone, The Daily Beast, Reuters and Desert Companion, among others.