Experts Sound the Alarm on Pricey Skin Substitutes in Wound Care Industry

The runaway costs of skin substitutes for treating chronic wounds have experts and accountable care organizations (ACOs) sounding the alarm, and new rules targeting profiteering in the industry are now in limbo under the Trump administration.

Regulators at the Centers for Medicare & Medicaid Services (CMS) argue that some of these skin substitutes, many of them human-derived, are being misused and their costs inflated by legally murky reimbursement schemes. And ACOs have often been on the hook for the bill.

One of the "most egregious" claims was for a patient in Florida who accumulated $9.8 million in costs over the course of about a year, according to David Klebonis, chief operating officer at the Palm Beach Accountable Care Organization in West Palm Beach, Florida.