California Clinic Accused in $34M Medicare Fraud Probe
Summary
Federal authorities are investigating a Pasadena clinic for allegedly billing Medicare more than $34 million for skin graft treatments that were never given. The clinic is accused of submitting unusually high claims for these procedures, leading to a large investigation and seizure of funds.Key Facts
- The clinic, Expert Wound Care PC (also called St. Victoria Home Care), billed Medicare over $46 million from late 2025 to early 2026.
- Medicare paid about $34 million for skin graft and wound care services that may not have been provided.
- The clinic’s billing for skin grafts was more than double the national average in cost per claim.
- Nearly all of the clinic’s Medicare payments were for skin substitute graft procedures.
- One patient’s claims accounted for over $6 million, but authorities say the treatments were not delivered.
- Medicare spending on skin substitute grafts nationwide rose from hundreds of millions in 2019 to over $10 billion in 2024.
- Medicare has started a flat rate for skin substitutes to help prevent overbilling and save money.
- Federal agencies are increasing efforts to fight Medicare fraud, especially in California, which is seen as high-risk.
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