A few choice excerpts from a NYT investigation, Medicare Bleeds Billions on Pricey Bandages, and Doctors Get a Cut:

For one patient in Nevada, Medicare spent $14 million on skin substitutes over the course of a year, according to billing records reviewed by The Times. The wound of a patient in Washington State persisted after Medicare paid $6 million for the coverings. A man in Texas got $1.3 million of bandages despite having no wound at all.

Five years ago, the most expensive skin substitute cost $1,042 per square inch, while some were as cheap as $45. Today, the three most expensive products on the market each cost more than $21,000. (Samaritan Biologics, a company in Memphis that sells the three products, did not answer questions about why they cost so much.)

For the first six months of a new bandage product’s life, Medicare will set the reimbursement rate at whatever price a company chooses. After that, the agency adjusts the reimbursement to reflect the actual price paid by doctors after any discounts.

To circumvent the reimbursement drop, some companies simply roll out new products.

The doctor who earned the most for skin substitutes last year was Dr. Aaron Jeng of Southern California, according to Early Read’s analysis. Medicare paid him $117 million. (Dr. Jeng declined to comment.)

Another high earner, Dr. Stephen Dubin of Las Vegas, was paid $17 million by Medicare for skin substitutes in 2024. (He estimated that after expenses, he took home roughly $4 million.) Dr. Dubin retired at the end of last year, in part, he said, because of increased competition for wound patients. Sometimes he would show up at a patient’s home only to find that someone from a different clinic had placed a new skin substitute the day before.

The article is 3 months old but still relevant: a day after it came out the administration announced that it was indeed delaying implementation of the new reimbursement rules until 2026. Wouldn’t it be neat if there were a government department that deals with this kind of fraud, waste and abuse?