{"id":4903,"date":"2026-06-27T01:46:27","date_gmt":"2026-06-27T01:46:27","guid":{"rendered":"https:\/\/www.insuracarelife.com\/blog\/the-906-million-wound-care-fraud-the-federal-government-caught\/"},"modified":"2026-06-27T01:46:27","modified_gmt":"2026-06-27T01:46:27","slug":"the-906-million-wound-care-fraud-the-federal-government-caught","status":"publish","type":"post","link":"https:\/\/www.insuracarelife.com\/blog\/the-906-million-wound-care-fraud-the-federal-government-caught\/","title":{"rendered":"The $906 million wound care fraud the federal government caught"},"content":{"rendered":"<div>\n<h2><strong>Commercial plans were explicitly in scope<\/strong><\/h2>\n<p>This is not a Medicare-only problem. The Apex Medical case &#8211; in which Alexandra Gehrke was sentenced to 15.5 years in prison on October 7, 2025, and Jeffrey King to 14 years on October 10, 2025, with a $309 million civil settlement announced in December &#8211; generated more than $1.2 billion in false claims over 18 months, of which over $960 million was billed to federal programs including Medicare, TRICARE and CHAMPVA, with the remainder billed to other health insurance programs, according to DOJ records. A related 2025 case involving co-defendants Kontos, Kupetz and Kinds made the commercial payer exposure explicit: the DOJ&#8217;s own case summary states their scheme submitted false claims to &#8220;Medicare, CHAMPVA, TRICARE, and commercial insurers.&#8221; Commercial insurers were directly in scope. The amounts paid by private plans have not been separately disclosed.<\/p>\n<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Commercial plans were explicitly in scope This is not a Medicare-only problem. The Apex Medical case &#8211; in which Alexandra Gehrke was sentenced to 15.5 years in prison on October 7, 2025, and Jeffrey King to 14 years on October 10, 2025, with a $309 million civil settlement announced in December &#8211; generated more than [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4904,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[196,3906,260,234,3049,511,3905],"class_list":["post-4903","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","tag-care","tag-caught","tag-federal","tag-fraud","tag-government","tag-million","tag-wound"],"_links":{"self":[{"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/posts\/4903","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/comments?post=4903"}],"version-history":[{"count":0,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/posts\/4903\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/media\/4904"}],"wp:attachment":[{"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/media?parent=4903"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/categories?post=4903"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/tags?post=4903"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}