Federal prosecutors seized more than $2 million from a Pasadena wound-care clinic bank account “suspected of scamming millions of dollars from Medicare” through reimbursements for skin grafts that patients allegedly never received, federal officials announced Tuesday.
Working with Department of Homeland Security Investigations, First Assistant U.S. Atty. Bill Essayli revealed that Expert Wound Care, which does business as St. Victoria Home Health Care, is the target of a federal inquiry. The Pasadena-based clinic is accused of fraud, according to a seizure warrant affidavit that federal prosecutors filed Monday and that a federal magistrate in Los Angeles approved.
The clinic received more than $34 million in federal payouts, with claims involving a single patient totaling more than $6 million, according to a U.S. Secret Service agent affidavit in the investigation. Expert Wound Care and its principals could be immediately reached for comment on Tuesday.
No charges have been filed against the clinic’s principals and the investigation remains ongoing.
The seizure is part of larger investigation into Medicare-funded wound care by the Centers for Medicare and Medicaid Services, or CMS. Dr. Mehmet Oz, administrator of the federal agency, told The Times in an interview early this year that his agency was tackling a massive fraud issue in the skin graft and wound care industry, with the agency was paying tens of thousands of dollars per square centimeter of treatment, and in some cases even for fake treatments.
Medicare reimburses providers for the use of skin substitutes for wound care. Skin substitutes are a group of biological and synthetic elements that enable the temporary or permanent closure of wounds. They have structural and functional characteristics that closely match skin.
Medicare spending on these products has seen unprecedented growth, rising to more than $10 billion in 2024 from $256 million in 2019, according to Medicare Part B claims data. In 2025, the CMS Fraud Defense Operations Center stopped nearly $185 million in improper payments to suspect providers billing for skin substitutes.
To curtail the spending, CMS in January implemented a flat national reimbursement rate for covered products in physician offices and hospital outpatient departments, a move it projects will save several billion dollars annually.
In the case of the Pasadena clinic, an affidavit written by Seth Tugg, a U.S. Secret Service agent, reveals that investigators believe the money is “traceable to the commission of a health care fraud offense” and to a conspiracy to commit such offense.
“A review of Medicare claims data revealed that between September 2025 and April 2026, EXPERT WOUND CARE PC submitted claims to Medicare totaling approximately $46,621,769.37 for skin substitute products and wound care services purportedly provided to seventy-eight (78) Medicare beneficiaries for dates of service between July 2025 and March 2026.” He added that Medicare approved payments of $34 million on the claims.
According to the affidavit, Expert Wound Care’s Medicare billings had a sixfold increase to approximately $33 million in December from $4.975 million in July. One beneficiary alone racked up $6,232,645.29 in billings to Medicare. On average, the business billed $299,639.45 per patient, according to the agent who worked with CMS investigators and Health and Human Services’ inspector general’s office.
“There is probable cause to believe that, based on national averages of similar providers, EXPERT WOUND CARE PC electronically submitted claims to Medicare seeking reimbursements for skin substitutes and skin grafts, primarily AMCHOPLAST and Tri-Membrane Wrap, that did not reflect the benefits actually provided to the beneficiaries,” the agent’s affidavit said.
Investigators interviewed five of the patients for whom the clinic billed Medicare seeking reimbursement for skin substitutes and skin grafts. They found that the listed Altadena Drive office was actually Victoria Home Care, which remained locked during surveillance.
One patient, only listed as J.L., for whom Expert Wound Care was paid more than $2 million to treat, told investigators that a man called Tony, a physician assistant, came three times a week to treat a flesh wound on his left calf. He never heard of the company and did not recognize the two practitioners.
The patient’s sister-in-law told investigators that a nurse practitioner “came to the home a few times to treat J.L.’s flesh infection and “did not treat the open wounds often because they were too infected.” The agent added, “according to her notes, J.L did not receive any type of home service in the month of December (despite the fact that twenty seven claims for services were filed on his behalf for services purportedly provided in December.)”
Essayli said the seizure from the Pasadena clinic is part of an ongoing investigation.
Oz, in an interview earlier this year, said his investigators had examined the massive overspending on skin substitutes and identified that a relatively small number of physicians are tied to the issue, and that the agency would address their specific role in the authorization, while slashing reimbursement rates.
This story originally appeared on LA Times
