Federal Prosecutors Seize $2 Million in Medicare Fraud Investigation of Pasadena Wound Care Clinic
Federal authorities have seized over $2 million from Expert Wound Care, a Pasadena-based clinic at the center of an ongoing Medicare fraud investigation, officials announced Tuesday.
The clinic, which also operates under the name St. Victoria Home Care, faces allegations of falsely billing Medicare for millions of dollars in skin graft treatments that investigators say patients never received. This seizure marks a significant action in efforts to crack down on fraud within the lucrative wound care industry.
Massive Medicare Billings Raise Red Flags
According to an affidavit filed and approved by a federal magistrate in Los Angeles, Expert Wound Care submitted Medicare claims totaling approximately $46.6 million between July 2025 and March 2026. Of this amount, Medicare reimbursed the clinic roughly $34 million. Notably, one single patient account showed billings exceeding $6 million.
Federal prosecutors, led by First U.S. Attorney Billie Essayli and working alongside the Department of Homeland Security Investigations and CMS, allege that the clinic vastly inflated claims and billed for services—specifically costly skin graft substitutes like AMCHOPLAST and Tri-Membrane Wrap—that were never actually provided.
Evidence from Surveillance and Patient Testimonies
Investigators uncovered multiple inconsistencies during surveillance and interviews. The clinic’s listed treatment site, located on Altadena Drive, remained locked with no staff observed, reportedly still operating under the St. Victoria Home Care name. Five patients listed on Medicare claims were interviewed; one, identified only as J.L., had over $2 million billed in his name.
J.L. recounted only occasional visits from a physician assistant named Tony with no affiliation recognized from Expert Wound Care, and his family stated wound care visits were infrequent and inadequate. Notes also confirmed that J.L. did not receive any home care services during December, despite billings during that period.
Widespread Medicare Fraud in the Wound Care Sector Under Scrutiny
Experts say this clinic is part of a broader Medicare fraud problem involving expensive skin substitute materials used in wound treatment. Medicare spending on these treatments skyrocketed from $256 million in 2019 to over $10 billion in 2026, leading CMS to implement a flat national reimbursement rate earlier this year to curb overspending.
CMS’s Fraud Defense Operations Center blocked nearly $185 million in improper payments to providers billing for these products in 2026 alone. Dr. Mehmet Oz, a CMS official, stated in an interview earlier this year that the agency was focusing on a small number of practitioners tied to fraudulent claims and planning strict measures against improper billing practices.
Investigation Ongoing, No Charges Filed Yet
While no criminal charges have been filed against Expert Wound Care or its principals, federal officials emphasize the seizure is a critical step in a continuing investigation. The U.S. Secret Service agent’s affidavit cites “probable cause” that the seized funds are linked to health care fraud and conspiracy.
Billie Essayli confirmed that the seizure is part of a sustained federal crackdown on Medicare-funded wound care fraud, signaling rigorous scrutiny ahead for providers with unusual Medicare billing patterns nationwide.
What’s Next?
The investigation remains active, with federal authorities expected to gather more evidence and potentially pursue formal charges. The case highlights the federal government’s intensified efforts to stop abuse in Medicare—a system serving millions of Americans, including Ohio residents.
For consumers and Medicare beneficiaries, this probe underscores the need for vigilance regarding unexpected treatments and billing. The Ohio healthcare community and nationwide providers are closely watching the fallout as authorities move to safeguard taxpayer funds.
