Louisville, KY – Heuser Health, a Louisville-based provider of at-home wound care services, has agreed to pay $2,646,186.72 to resolve allegations that it violated the False Claims Act by overbilling Medicare and TRICARE for costly skin substitute products. This settlement is part of a broader investigative initiative known as “Operation Skin Scam,” aimed at uncovering fraud schemes involving expensive skin substitute materials and holding accountable those who attempt to exploit them.
Skin substitutes are advanced bioengineered or tissue-derived materials used to replace, imitate, or regenerate damaged skin. Heuser Health used these products to treat Medicare and TRICARE beneficiaries suffering from chronic and acute wounds. Federal rules required Heuser Health to bill these products based on their actual invoice price.
The United States alleges that Heuser Health submitted, or caused to be submitted, claims using invoice amounts higher than the company’s true purchase prices, leading to inflated reimbursements paid by Medicare and TRICARE.
“Healthcare providers must bill federal healthcare programs accurately and transparently,” said United States Attorney Kyle G. Bumgarner for the Western District of Kentucky. “When providers seek reimbursement beyond what they are entitled to receive, it undermines the integrity of Medicare and TRICARE and misuses taxpayer funds. This settlement—part of our wide ‘Skin Scam’ effort—reflects our commitment to enforcing federal billing rules and protecting these essential programs from abuse.”
The matter was handled by Assistant United States Attorneys Matt Weyand and Jessica R. C. Malloy with investigative assistance from Auditor Phil Bezehertny of the U.S. Attorney’s Office.
The claims alleged by the United States are allegations only. There has been no determination of liability.
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Source: U.S. Attorney’s Office — Western District of Kentucky — U.S. Department of Justice press release.