Pasadena Wound Care Clinic Accused of Medicare Fraud After $2M Federal Seizure

Federal authorities have seized more than $2 million from a Pasadena-based wound care clinic accused of submitting fraudulent claims to Medicare for skin graft procedures and related services that allegedly were never performed. According to the Department of Justice, the clinic, Expert Wound Care PC, billed Medicare more than $46.6 million over a seven-month period for wound care products and procedures purportedly provided to just 78 beneficiaries. Federal investigators allege the clinic received more than $34 million in Medicare reimbursements tied to those claims.

Investigators identified significant billing irregularities, including claims for skin grafts that patients reportedly never received and reimbursement levels dramatically exceeding national averages for similar procedures. One beneficiary alone allegedly generated more than $6.2 million in Medicare payments, while another patient was billed for dozens of services during a month in which no home treatment allegedly occurred. The seizure was authorized by a federal magistrate judge as part of an ongoing healthcare fraud investigation led by Homeland Security Investigations and the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG).

The case highlights increasing federal scrutiny of advanced wound care billing practices and the use of data analytics to identify potentially fraudulent Medicare claims. It also underscores the importance of whistleblowers and qui tam actions in helping investigators uncover suspicious billing trends and protect federal healthcare programs from fraud and abuse.