Federal Prosecutors Seize $2 Million in Medicare Fraud Probe Targeting Pasadena Clinic
Federal authorities seized more than $2 million from Expert Wound Care, a Pasadena wound care clinic, as part of an ongoing investigation into alleged Medicare fraud involving tens of millions in fraudulent billings for skin graft treatments patients never received. The seizure was authorized by a federal magistrate in Los Angeles following an affidavit filed Monday revealing alarming billing practices.
Expert Wound Care, which operates as St. Victoria Home Care, reportedly submitted Medicare claims exceeding $46 million for skin substitute products and wound care services between July 2025 and March 2026, according to court documents. Medicare paid out more than $34 million on these claims during that period.
Explosive Billing Spike Raises Red Flags
Investigators noted a six-fold increase in billings, surging from approximately $5 million in July 2025 to nearly $33 million by December. One patient alone accounted for more than $6.2 million in Medicare reimbursements. The average billing per patient was nearly $300,000.
A U.S. Secret Service agent involved in the probe stated the payments are “traceable to the commission of a health care fraud offense and a conspiracy to commit such offense.” Investigators allege that Expert Wound Care submitted false claims for skin substitutes, including products like AMCHOPLAST and Tri-Membrane Wrap, which were not actually provided to beneficiaries.
Patients Question Legitimacy of Care Received
Federal investigators interviewed five patients listed in the Medicare claims and found inconsistencies in treatment provided. One patient, identified only as J.L., reportedly received limited home visits and was unfamiliar with the clinic’s staff. The purported treatment location on Altadena Drive was found locked and identified as Victoria Home Care, a separate facility.
J.L.’s sister-in-law told investigators that wound treatments were infrequent and limited due to infection severity, contradicting extensive claims submitted to Medicare on his behalf. These discrepancies deepen concerns about the legitimacy of services billed by the clinic.
National Crackdown Amid Exploding Medicare Spending on Skin Substitutes
Medicare spending on skin substitute products has skyrocketed nationwide, rising from $256 million in 2019 to over $10 billion in 2024, fueling widespread scrutiny into the wound care industry’s billing practices. Medicare reimburses providers based on the size of treated wounds, paying tens of dollars per square centimeter.
This dramatic escalation has prompted federal agencies and the Centers for Medicare & Medicaid Services (CMS) to intensify efforts against fraud. In 2026 alone, CMS blocked nearly $185 million in improper payments for skin substitute claims, forcing a January rollout of a national flat reimbursement rate aimed at curbing wasteful overpayments.
First U.S. Attorney Billie Essayli confirmed the seizure is part of a broader crackdown targeting fraudulent wound care billing schemes. “The investigation remains ongoing,” Essayli said, noting that no charges have yet been filed against Expert Wound Care or its principals.
Federal Agencies Unite Against Medical Fraud
The probe into Expert Wound Care involves multiple federal agencies including the Department of Homeland Security Investigations, the U.S. Secret Service, the CMS Fraud Defense Operations Center, and the HHS Office of Inspector General.
Earlier this year, Dr. Mehmet Oz highlighted the massive fraud risk in skin graft treatments, identifying a small number of providers driving excessive billings. The CMS response strategy aims to reduce incentives for fraudulent claims while targeting providers involved in improper authorization and billing.
What’s Next?
Authorities are continuing to analyze Medicare claims data and patient records related to Expert Wound Care. Further seizures and potential indictments could follow depending on the outcome of the ongoing investigation.
For Colorado and across the U.S., this case underscores intensified federal vigilance aimed at protecting taxpayer funds and combating complex health care fraud schemes exploiting Medicare.
Stay tuned as this federal investigation into Medicare fraud unfolds, revealing the potential scope of abuse within the skin graft and wound care payments nationwide.
