Arizona couple pleads guilty in vast $1.2B skin graft false claims case

Two owner-operators of three Arizona medical companies have pleaded guilty to billing more than $1.2 billion in false and fraudulent claims to Medicare and other government health programs in less than two years, the Department of Justice (DOJ) said.

Medicare, the health insurance program for the elderly, requires that the health care given to patients, including supplies and procedures, is necessary, as determined by a provider who has not been influenced by incentives, including cash or gifts. Medicare considers it fraudulent for a supplier or provider to bill the agency for unnecessary care.

Alexandra Gehrke, created and owned two companies, Apex Medical LLC and Viking Medical Consultants, LLC, that from Nov. 2022 through May 2024 paid sales agents to seek out any elderly patients with any wounds at any stage and to order a particular type of wound graft, similar to a bandage, from a particular distributor.