UMMS is already facing questions about how it accounted for its relationship with Pugh in the IRS filings, known as 990s. The medical system paid Pugh $500,000, in five installments of $100,000 from 2011 to 2018, to purchase 100,000 copies of her self-published Healthy Holly books. In its tax filings for 2015 and 2017, UMMS listed the $100,000 book payments as grants — one to her company directly and the other to the Baltimore City School Systems — even though it has called the payments purchases.