Subcommittee on Health Care and Financial Services Chairman Glenn Grothman delivered opening remarks at a roundtable titled “Medicare Fraud: Examining the Explosive Growth in Skin Substitute Spending” on July 21. Grothman said there has been a 7,100 percent increase in Medicare claims for skin substitute procedures over the last six years, despite many of these procedures being medically unnecessary for patients. He said this trend suggests ongoing waste, fraud, and abuse within the program.
Grothman outlined that the purpose of the roundtable was to understand how Medicare became vulnerable to such dramatic spending growth, assess whether recent reforms have been sufficient, and discuss what additional steps Congress and federal agencies should take to protect patients while ensuring responsible providers can continue delivering care.
In his prepared remarks, Grothman welcomed participants and addressed “rampant fraud involving skin substitutes in wound care.” He referenced a press conference with the White House Task Force to Eliminate Fraud led by Vice President JD Vance, where both Vance and Centers for Medicare & Medicaid Services Administrator Dr. Oz discussed the spike in claims. Skin substitutes are biosynthetic or tissue-derived wound coverings used for severe burns, surgical defects, and chronic wounds.
Grothman said that fraud is highly concentrated in assisted living facilities and skilled nursing facilities. Investigations by the Department of Justice, Department of Health and Human Services Office of Inspector General, and Centers for Medicare & Medicaid Services revealed patterns of providers billing for medically unnecessary procedures or submitting claims for services never provided. Between 2019 and 2025, public spending on skin substitutes increased from $200 million to $14.4 billion.
He questioned whether existing reimbursement policies created incentives that bad actors exploited, but emphasized that most healthcare providers act ethically. Grothman credited reforms implemented by CMS during the Trump administration with reducing excessive billing practices. He also noted enforcement actions pursued by the Department of Justice against those alleged to have engaged in fraudulent conduct.
“We want to better understand how these fraud schemes operate,” Grothman said during his closing remarks. “I appreciate our participants being here today to share their expertise.”