2025 National Health Care Fraud Takedown

Wound Care Fraud Cases: Amniotic Allografts & Skin Substitutes by State - June 30, 2025

🎯 Key Findings Summary - June 30, 2025 Takedown

Total Fraud: $1.29+ Billion in wound care-related fraud schemes
Primary States: Arizona ($1.1B), Texas ($90M), Nevada ($94M), Washington (undisclosed)
Defendants: 11 medical professionals charged in wound care fraud
Target Patients: Vulnerable elderly, many in hospice care, with unnecessary wound treatments

Total Wound Fraud

$1.29+ Billion

Combined amniotic & skin substitute fraud

Defendants Charged

11

Medical professionals in takedown

Assets Seized

$7.2+ Million

Cash, cryptocurrency, luxury items

States Affected

4

Arizona, Texas, Nevada, Washington

Arizona Cases (District of Arizona) - $1.1 Billion
June 30, 2025 Takedown
Amniotic Allografts
Ira Denny (56, Surprise, AZ) - Nurse Practitioner
Applied medically unnecessary amniotic allografts to elderly Medicare beneficiaries without exercising independent medical judgment. Followed directions from medically untrained sales representatives.
Medicare Billed: $209.4M | Paid: $138.6M
June 30, 2025 Takedown
Amniotic Wound Allografts
Tyler Kontos (29, Mesa, AZ), Joel "Max" Kupetz (36, Scottsdale, AZ), Jorge Kinds (49, Phoenix, AZ)
Targeted elderly Medicare patients, many terminally ill in hospice care. Applied unnecessary and expensive allografts indiscriminately to superficial wounds. Assets seized including cryptocurrency and bank accounts totaling more than $7.2 million.
$1 Billion Wound Allograft Scheme | $600M Paid by Medicare in 14 months
June 30, 2025 Takedown
Amniotic Allografts
Gina Palacios (40, Phoenix, AZ) - Nurse Practitioner
Applied amniotic allografts to elderly Medicare beneficiaries based on sales representative directions without exercising independent medical judgment.
Medicare Billed: $59.5M | Paid: $28.4M
Texas Cases (Southern District of Texas) - $90 Million
June 30, 2025 Takedown
Skin Substitutes
Dr. David Jenson (57, Spring, TX) - Podiatrist
Fraudulently billed Medicare for over $90 million for skin substitute products, often for patients who did not have qualifying wounds or any wounds at all. Continued billing even after 2023 audit denied all claims.
Medicare Billed: $90M | Continued billing after audit denial
June 30, 2025 Takedown
Skin Substitutes
Nestor Rafael Romero Magallanes (29, Spring, TX)
CEO of clinic involved in fraudulent Medicare billing scheme for skin substitutes. Falsified medical records to make it appear patients had chronic wounds and manipulated documentation.
Part of $90M Skin Substitute Scheme
Nevada Cases (District of Nevada) - $94 Million
June 30, 2025 Takedown
Amniotic Allografts
Paulino Gonzalez (40, Las Vegas, NV) - Registered Nurse
Received approximately $7.4 million in illegal kickbacks from allograft distributor in exchange for recommending purchasing and ordering of allografts. Wound care company billed Medicare over $94 million.
Medicare Billed: $94M | Kickbacks Received: $7.4M
June 30, 2025 Takedown
Amniotic Allografts
Mary Huntly (67, Las Vegas, NV) - Nurse Practitioner
Charged with conspiracy to defraud the United States and pay/receive health care kickbacks for participating in amniotic allograft scheme.
Part of $94M Wound Care Scheme
Washington State Case (Western District)
June 30, 2025 Takedown
Amniotic Products
Pinnacle Health PC (Seattle, WA)
Civil settlement for billing Medicare and Tricare for injectable form of amniotic fluid product (FlowerAmnioFlo) that was experimental and not approved for any diagnosis. CMS had only approved sheet form for very limited purposes.
Civil Settlement (Amount Not Disclosed)

📊 Wound Care Fraud Patterns Identified

Vulnerable Targets: Elderly patients, many receiving hospice care or terminally ill
Kickback Schemes: Sales representatives paying illegal kickbacks to medical professionals
Medical Necessity: Treatments applied without proper medical assessment or for superficial wounds
Billing Fraud: Oversized applications, falsified records, continued billing after audit denials
Product Types: Amniotic allografts, bioengineered skin substitutes, cellular tissue products

⚠️ Important Legal Disclaimer

All charges are allegations. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law. This information is based on publicly available DOJ press releases from the 2025 National Health Care Fraud Takedown announced on June 30, 2025. Civil settlements do not constitute admissions of liability. This chart focuses specifically on wound care-related fraud cases from the June 30, 2025 takedown.