Skyrocketing spending on skin substitutes: Medicare spent how much?

In 2024, Medicare spending on skin substitutes used in wound treatment had increased to more than $10 billion. Is there fraud involved? While federal reviewers cannot say the total increase is due to fraud, but the situation certainly caught the attention of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). David Tawes, MA, regional inspector general in the Baltimore, Maryland, HHS-OIG Office of Evaluation and Inspections, explains.

Medical Economics: The little things can add up, and I wanted to ask if you could give an idea about the total dollar amounts involved here.
David Tawes, MA:So, in 2024, Medicare expenditures had increased by more than seven-fold from just two years earlier in 2022. So they now exceed $10 billion annually, and estimates are that it will hit $15 billion in 2025.

Medical Economics: When you talk about an increase of that magnitude and and some of the factors and causes behind it, are there indications that the increases in billing were for skin substitutes were due to fraud?

David Tawes, MA: So, we can't say exactly what percentage of the payment increases are due to fraud, but it definitely appears to be a significant issue, given the high payment amounts, in many cases much higher than their cost. Skin substitutes seem particularly vulnerable to fraud, waste abuse, and there's been numerous investigations that have come back with findings of fraud.