Fake Diagnosis, Real Money : Florida Immunologist Allegedly Faked Rare Disease to Bilk Medicare of $1.9 Million — Patients Got Costly Treatments They Didn’t Need, Feds Say

The U.S. government has filed a civil lawsuit against a Naples, Florida, immunologist, alleging he submitted false Medicare claims tied to costly immune therapy treatments, federal officials said.

The complaint, filed in federal court, names Dr. Kevin Rosenbach and his medical practice, Kevin P. Rosenbach, M.D. P.A. Prosecutors allege that Rosenbach knowingly caused false claims to be submitted to Medicare Part B for subcutaneous immune globulin treatments.

According to the complaint, Rosenbach altered or added diagnoses to indicate that certain patients had a rare immunodeficiency condition, making them eligible for Medicare coverage of the treatments. Authorities allege that some patients did not meet the criteria for the diagnosis.

The government claims that these actions led specialty pharmacies to submit claims for the treatments, resulting in more than $1.9 million in losses to Medicare.

Federal officials said the case is part of ongoing efforts to protect taxpayer-funded healthcare programs from fraud and abuse.

The lawsuit was investigated by the Department of Justice and the Department of Health and Human Services Office of Inspector General. It is being handled by federal prosecutors in the Middle District of Florida.

The allegations in the complaint have not been proven in court, and no determination of liability has been made.

One Doctor Faked a Rare Illness. The Other Billed for Skin That Was Never Placed. Together, They Allegedly Stole Millions From Medicare — While Real Patients Were Just Billing Codes

Federal authorities have seized more than $2 million from a Southern California wound care clinic as part of an ongoing investigation into alleged Medicare fraud, according to the U.S. Attorney’s Office for the Central District of California.

A federal magistrate judge authorized the seizure of approximately $2.04 million from a bank account associated with Expert Wound Care PC, a Pasadena-based clinic accused of billing Medicare for procedures that were not performed.

According to court filings, investigators allege that between September 2025 and April 2026, the clinic submitted more than $46.6 million in claims to Medicare for skin substitute products and wound care treatments purportedly provided to 78 patients. Medicare paid out roughly $34 million on those claims.

Billing patterns at the clinic significantly exceeded national averages. During part of the period under review, the clinic averaged more than $37,000 per claim for skin substitute grafts—more than double the national average of about $16,800. Investigators also pointed to a sharp increase in billing activity, with the clinic’s Medicare claims rising from less than $5,000 in July 2025 to approximately $33 million by December of that year.

Court documents detail what investigators describe as particularly suspicious billing tied to individual patients. In one case, Medicare paid more than $6.2 million for treatments attributed to a single beneficiary. In another, the clinic billed more than $2.6 million and received about $2 million for procedures allegedly performed on one patient over several months. Authorities said that patient did not receive any of the billed skin grafts or related services, despite dozens of claims submitted on their behalf.

Officials also noted that a disproportionately high percentage of the clinic’s patients were billed for skin substitute procedures compared to national benchmarks, raising further concerns about the legitimacy of the services.

The seized funds represent proceeds that investigators believe are tied to fraudulent billing.

Federal prosecutors handling the forfeiture action as authorities continue to examine the scope of the alleged scheme. No criminal charges have been announced, and the allegations have not been proven in court.

Your Surgeon Wasn’t Licensed — And That Injection Wasn’t Necessary : Texas Surgery Centers Settle Back-to-Back Fraud Allegations — Taxpayers and Military Families Footed the Bill for Fake Credentials and Inflated Procedures

A Texas ambulatory surgery center has agreed to pay more than $46,000 to resolve allegations that it billed a federal healthcare program for services performed by an unlicensed employee, federal officials said.

PSA Ambulatory Surgery Center of Killeen, LLC entered into a $46,730 settlement with the U.S. Department of Health and Human Services Office of Inspector General following a self-disclosure of the conduct. The agreement resolves allegations that the facility submitted claims to TRICARE for services provided by a nurse who did not have a valid license at the time.

According to authorities, the settlement amount reflects the full salary and benefits paid to the individual during the period in which the nurse was allegedly unlicensed. Officials said federal healthcare programs require that services be performed by properly credentialed professionals to ensure patient safety and compliance with billing standards.

The case was handled under the Civil Monetary Penalties Law, which allows the government to impose financial penalties for improper claims submitted to federal healthcare programs. The resolution does not include a determination of liability.

In a separate but related enforcement effort involving healthcare providers in the same region, federal and state authorities previously reached a significantly larger settlement with a pain clinic and affiliated surgery center over alleged over-billing practices. In that case, Integrated Pain Associates and Central Texas Day Surgery Center agreed to pay more than $836,000 to resolve allegations that they billed Medicare, Medicaid, and TRICARE for more procedures than were actually performed.

According to those allegations, providers inflated the number or complexity of treatments such as spinal injections and related procedures to increase reimbursements from government healthcare programs. That case was investigated by multiple agencies, including the Department of Health and Human Services Office of Inspector General and the Defense Criminal Investigative Service, and stemmed in part from a whistleblower lawsuit.

Federal officials said both cases underscore continued efforts to monitor healthcare billing practices and safeguard taxpayer-funded programs from fraud and improper payments.

The allegations in both matters were resolved through civil settlements and have not been proven in court.