It’s being called the largest health care fraud takedown in U.S. history. A total of 324 defendants, including doctors, marketers, and medical executives, are accused by the Department of Justice of defrauding our Medicare system and other programs of more than $14.6 billion.
And at the center of several cases are a handful of wound care companies accused of unethically using advanced care products, including amniotic grafts, on vulnerable patients who didn’t need them in the first place.
As a mobile advanced wound care company committed to healing the millions of people battling chronic wounds, we’re deeply disappointed and, frankly, outraged to see how so many vulnerable patients have been exploited for profits.
Sadly, though, we’re not surprised.
Whether you’re a healthcare referral partner, a patient, or a loved one of someone dealing with a chronic wound, this case is more than a headline. It’s a wake-up call.
Here’s what you need to know.
A Breakdown of the Case
The DOJ’s case targeted numerous types of medical companies, including durable medical equipment (DME), telemedicine practices, and genetic testing labs.
In terms of wound care, charges were filed in the District of Arizona and District of Nevada in connection to fraudulent claims to Medicare and other benefit programs. The cases centered around amniotic allografts, which are advanced biologics used in chronic wound care. The use of these grafts, also referred to as skin substitutes, has soared over the past five years, with spending exceeding $10 billion in 2024.
The companies were accused of targeting elderly and hospice patients with graft treatments without the coordination of any physicians or infection control measures. The alleged treatments were done to superficial wounds or excessively large areas.
Specifically in Arizona, Alexandra Gehreke and Jeffrey King orchestrated a $1.2 billion fraud scheme involving medically unnecessary amniotic wound grafts. They paid untrained sales reps to push oversized grafts for maximum insurance reimbursement and directed nurse practitioners to apply them regardless of medical necessity. They ultimately pleaded guilty to their charges and now await sentencing, potentially facing 20 years in prison.
How This Harms Patients
This entire case not only puts a black eye on the advanced wound care industry, but creates an erosion of trust in the entire system. Families and patients were misled, causing emotional and psychological harm, and expensive life-saving grafts that could be used for qualified patients with chronic wounds were wasted.
“This was happening to patients who were receiving end of life care on hospice and otherwise couldn’t advocate for themselves,” said Dr. Christopher Mason, physician-owner of Rebirth Advanced Healing.
While no deaths were reported, the damage is undeniable: unnecessary procedures, violated consent, and a growing skepticism of providers — even the ones who are doing things the right way.
“At the end of the day, these were business interests putting profits before patients with the sole goal of generating revenue,” Mason added.
How to Spot Red Flags
If you have a patient or a loved one dealing with a chronic wound, it’s now natural to wonder how this can be prevented in the future. While many providers work with integrity, it’s important to stay informed and alert.
These are some common red flags to watch for when evaluating a wound care provider.
- Is it a physician-owned practice? In many states, it’s illegal for a wound care practice (or any medical practice) to be owned by a non-physician. Corporate Practice of Medicine (CPOM) laws are in place to keep healthcare decisions separate from corporate profit motives. So, find out the ownership of a wound care company you’re potentially working with and determine if it’s in your best interest. Rebirth Advanced Healing is 100% physician-owned with no private equity stakes in its operations.
- No consultation with the patient’s primary doctor. Before any advanced treatment is even considered, it’s essential to consult with the patient’s doctor and review their full medical history. Additionally, a patient needs at least 28 days of documented wound care using traditional, conservative treatments before advanced therapies can even be considered.
- Advanced treatment offered for minor wounds. There are strict Medicare guidelines on what types of chronic wounds can receive advanced treatment. Minor wounds, or wounds that have shown documented signs of improvement over the course of about a month are not eligible for amniotic grafts.
- Promises of healing. Amniotic grafts have shown great potential in the fight against chronic wounds, but nothing is guaranteed. Any wound care company promising perfect results should be treated as a red flag.
- Unclear pricing or billing practices. Transparency is key when dealing with any medical practice. Patients and loved ones of patients need to know what’s being covered by insurance.
What Ethical Wound Care Looks Like
These Medicare fraud cases exposed what happens when wound care is driven by profit, not patients.
But not every provider operates that way, including our team at Rebirth Advanced Healing.
Here’s how our treatment follows medical evidence and puts patients first.
Full Clinical Assessment
Our team wants to know your patient’s complete medical history. That includes reviewing the full documentation of the wound, infection screening, and the medical history. This is needed to determine if advanced therapies are appropriate or not.
Medicare Guidelines Followed
There are specific Medicare guidelines that teams follow to ensure a patient with a chronic wound is eligible for advanced treatments, like grafts. Specifically, the wound can’t have decreased in size by 50% over the course of 28 days. Additionally, the wound must be at least 1 centimeter in diameter; the wound cannot have any active infection, the wound bed must be viable with beefy red tissue; and the patient cannot be on hospice.
Coordination with Care Team
We work closely with your current care team, be it your doctor, or your team at a home health agency. If and when advanced treatment is approved, we coordinate with the care team to ensure seamless support for the patient at every step.
Healing Outcomes Tracked
Our team closely documents every step of your healing journey. Not to just keep you and your caretakers informed, but to ensure treatments are working, wounds are progressing as expected, and decisions are always backed by real clinical data.
A Better Path Forward with Rebirth
These types of fraud cases should never happen in the first place. But it’s a symptom of the system that too often puts billing ahead of healing.
At Rebirth Advanced Healing, we’re working to make wound care transparent, collaborative, and accountable. That means using advanced therapies only when needed. And keeping patients and loved ones of patients informed, coordinating with care teams, and tracking real outcomes.
The last thing a patient with a chronic wound should have to question is whether the care they’re receiving is actually for them.
If you or a loved one is dealing with a chronic wound that won’t heal, reach out to us and start that conversation.
