DOJ Indicts Multiple Providers for Fraudulent Use of Amniotic Skin Substitutes
On July 1, 2025, Dr. Caroline Fife reported on new Department of Justice indictments involving fraudulent billing of medically unnecessary amniotic cellular tissue products—often marketed as “skin substitutes”—primarily targeting elderly or vulnerable patients in nursing homes and hospice care.
Key Highlights:
- Scope of Fraud: Seven defendants—including nurse practitioners and a nurse—are accused of billing Medicare for unnecessary amniotic allografts in exchange for kickbacks from distributors, totaling up to $1 billion in claims :contentReference[oaicite:1]{index=1}.
- Key Allegations: Providers allegedly performed procedures on end-of-life patients without independent medical decision-making, following directives from untrained sales reps :contentReference[oaicite:2]{index=2}.
- Notable Cases: Examples include Gonzalez in Las Vegas—charged with applying unnecessary allografts tied to payoffs—and others (Huntly, Denney, Kontos, Kupetz, Kinds, Palacios, Rios, Rasmussen) engaged in kickback schemes and billing fraud :contentReference[oaicite:3]{index=3}.
- Additional Fraud Tied to HBOT: A revealing case involving hyperbaric oxygen therapy fraud by Yvonne Petrie used stolen physician identifiers to submit $1.9 million in false HBOT claims :contentReference[oaicite:4]{index=4}.
This crackdown signals intensified DOJ scrutiny on opportunistic misuse of expensive wound care products—especially in vulnerable populations and settings lacking physician oversight.
Source: Caroline Fife, M.D., “More Info on the Individuals Indicted by the DOJ Around the Use of ‘Skin Substitutes,’” CarolineFifeMD.com, July 1, 2025.
Keywords: skin substitute fraud, amniotic allograft, DOJ indictments, Medicare kickbacks, hospice care