Last year, Medicare spent over $10 billion on dubious bandages—called skin substitutes—that come with eye-popping prices. Some are made from medical waste, like dried bits of discarded placentas or infant foreskin, and many have not gone through rigorous testing to prove they offer any advantage over standard bandages. Yet, in some cases, Medicare reportedly paid for bandages priced at more than $21,000 per square inch. And individual patients have quickly racked up bills over $1 million just for their bandaging—some who puzzlingly didn't even have a wound.
Private insurance companies largely do not cover these bandages, declaring many of them "unproven and not medically necessary." But Medicare's current coverage seems to tie back to a rule change in 2020 that opened the door to broader use of them—and the market for these dubious skin substitutes, often used for diabetic ulcers, exploded. Since 2023, more than 100 new products have been introduced, according to an investigative report from The New York Times in April.
The Times investigation highlighted two big reasons why they're so pricy: First, due to an oddity in pricing rules, Medicare initially sets the reimbursement rate for the bandages at whatever price the manufacturer chooses—for the first six months at least. The second is that doctors are granted steep discounts, incentivizing them to use the pricy products for bigger reimbursements. After the initial six-month period, Medicare reimburses only what doctors pay after manufacturer discounts. However, some bandage makers get around this by just rolling out new products that are suspiciously similar to the old ones, maintaining the large reimbursement rates.
Sean "Diddy" Combs' prosecutors are beginning to wrap up their Manhattan sex-trafficking case.
"Jane," their third and last sexual-assault witness, is taking the stand on Thursday.
Prosecutors say Combs sex-trafficked her from 2021-2024. She is also key to a racketeering charge.
A final sexual assault witness testified on Thursday that agreeing to have sex with male escorts while Sean "Diddy" Combs watched and directed their actions opened up a "Pandora's box" she could not close.
"It was just a door I was unable to shut," said the witness, testifying under the pseudonym "Jane."
"It was so much of it," she said of the drug-fueled, dayslong sexual performances that she and Combs called "hotel nights."
"It was too much of it," she told the jury.
Jane is due to testify this week and next at Combs' federal trial in Manhattan, with her testimony meant to bolster the two top charges of sex trafficking and racketeering.
Her testimony follows that of R&B singer and sex-trafficking witness Cassie Ventura, who said Combs coerced her into humiliating sex with male escorts in the 10 years ending in 2018. Former Combs employee "Mia" has also testified and said he sexually assaulted her at least four times between 2009 and 2017.
Jane is the millionaire music and lifestyle mogul's last victim before his arrest, according to the indictment.
Prosecutors say Combs sex-trafficked Jane —meaning forced her to cross state lines to engage in sex with paid male escorts — between 2021 and 2024, the year he was arrested at the Park Hyatt, a Manhattan luxury hotel.
Inside Combs' hotel room, investigators recovered bags of ketamine and ecstasy powder, a blue party light, and more than a dozen bottles of baby oil and sexual lubricants, a Department of Homeland Security investigator testified during the trial's first week.
Prosecutors have previously described these items as the ingredients for freak offs, the dayslong sexual performances at the center of the sex trafficking case. Prosecutors have suggested that Jane will testify to having participated in Combs' final freak off — or "hotel night," as she called them — at that hotel.
On Thursday, Jane told the jury that she agreed to the first encounter in 2021 because she loved Combs and wanted to make him happy. She conceded on the stand that she felt "exhilarated" afterward.
Still, "I didn't think that we would be doing that again," she told the jury. "I figured it was something we did that one time, and maybe on a random night we might do it again."
She said she soon realized that participating was the only way Combs would agree to have sex with her.
But when she would tell him she wanted to stop having the encounters, which jurors have also heard were called "freak offs" and "king nights," Combs would abruptly brush her off.
"I could just feel the tension was building," she said. Combs would tell her, "We don't have to," and "That's fine," she said, and then quickly changed the subject.
Ultimately, she said, "We would just do it" again.
Prosecutors have also said that Combs could be violent with Jane. In openings last month, they described Combs chasing her through the rooms of the house he paid for her to live in in Los Angeles, breaking down doors as she tried to escape.
Sean Combs is accused of sex trafficking women right up to the year of his arrest.
Jane Rosenberg/REUTERS
Jane's testimony may be key to proving not just sex trafficking, but racketeering as well. Racketeering requires proof that Combs, through his business empire, committed at least two underlying crimes.
Those potential underlying crimes include sex trafficking. They also include bribery and obstruction of justice, two crimes that prosecutors have alleged that Jane witnessed.
During her May 12 opening statements, Emily Johnson, an assistant US attorney, told the jury that Combs and his family members repeatedly reached out to Jane in an attempt to influence her testimony against him.
"You will hear him try to manipulate Jane into saying she wanted freak offs," Johnson said in her opening, describing a recorded phone call she promised the jury would hear.
"You will hear him interrupt Jane when she pushes back," the prosecutor added.
Prosecutors say Combs made sure that Jane would continue to receive housing payments from him after his arrest, something they may describe as a bribe.
Combs, 55, has pleaded not guilty to the indictment, through which he risks a maximum potential sentence of life in prison.
His lawyers have insisted that all sexual contact in the indictment was consensual, and they have described his business activities as legitimate and not constituting a criminal "racket."
The trial may continue into early July, depending on the length of the defense case, which is expected to begin in mid-June.
This story has been updated with additional detail from Jane's testimony.
50 Cent later took an online jab at Combs over the Tuesday testimony from Combs' former personal assistant and top executive, Capricorn Clark.
While on the witness stand in Manhattan federal court, Clark was asked by prosecutor Mitzi Steiner whether Clark ever heard Combs discuss guns during her stint working for the music tycoon.
Clark responded "once" and then went on to describe a time following an MTV press event that involved 50 Cent, whose real name is Curtis Jackson III.
Following the event, which both Combs and Jackson attended, Clark told the jury that Combs mentioned the rappers' beef to late music manager Chris Lighty, who at the time represented both men.
Music manager Chris Lighty represented Sean "Diddy" Combs and 50 Cent.
Johnny Nunez/WireImage
Lighty, who also managed artists like Missy Elliott, Busta Rhymes, and Mariah Carey, was found dead from a gunshot wound in his Bronx apartment in 2012. His death was later ruled a suicide by the New York City medical examiner.
Combs "was doing MTV press with 50 Cent and after the interview wrapped up, myself, Puff, and Chris Lighty got in the elevator," Clark said, referring to Combs as "Puff."
Clark testified that while in the elevator, "Puff told Chris, because they were having some sort of issue, like, 'I really don't like all the back and forth, I don't do that, I like guns.'"
"And what's the issue, with an individual?" the prosecutor asked.
"He had an issue with 50 Cent," Clark said.
Clark — who also testified that Combs kidnapped her at gunpoint in 2011 and made threats against her life — said Combs' demeanor was "very serious" when he brought up his fondness for guns.
Following the testimony, Jackson took the opportunity to troll Combs on Instagram writing in a caption: "Wait a minute PUFFY's got a gun, I can't believe this I don't feel safe 😔LOL."
The feud publicly erupted when Jackson released a 2006 diss track accusing Combs of knowing who killed rapper Notorious B.I.G. in 1997.
Combs' trial is now in its third week.
Prosecutors allege that for two decades, the one-time near-billionaire led a criminal enterprise that involved the sex trafficking of his ex-girlfriend, R&B singer Cassie Ventura, and another woman.
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