Why It Matters

Medicare’s skin substitute market is in crisis. Spending exploded from $256 million in 2019 to over $10 billion in 2024, driven by what federal auditors say is rampant fraud and pricing abuse. The HHS Office of Inspector General documented "concerning trends" in September 2025, including schemes where home-based wound care costs quadrupled compared to office settings.

CMS responded in October 2025 with dramatic payment cuts, slashing reimbursement by roughly 90 percent starting this month. The industry is now fighting back with the bipartisan Skin Substitute Access and Payment Reform Act, seeking to replace CMS’s flat rates with a "volume-weighted average" pricing formula that would deliver higher payments.

By the Numbers

Acesso Biologics has invested $420,000 in federal lobbying since early 2025. The company’s latest move—retaining Holland & Knight LLP for $50,000 in Q4 2025—marks its third lobbying firm in under a year, following $240,000 to Michael Best Strategies LLC and $130,000 to McManus Group.

Acesso’s team includes Miranda A. Franco, a veteran Medicare reimbursement expert, and Jordan K. Brossi, a former health policy adviser to Rep. Anna Eshoo. Notably, this same duo represents competitor ConvaTec Advanced Tissue Technologies for $80,000 on identical issues, suggesting industry coordination.

The Agenda

Acesso is specifically lobbying on Medicare coverage of wound care therapies and the Skin Substitute Access and Payment Reform Act of 2025 (S.2561/H.R. 5768). The bipartisan bills would establish a new Medicare payment methodology for skin substitute products effective January 1, 2026, based on volume-weighted averages rather than CMS’s current pricing structure.

Broader Context

The wound care industry is navigating dramatic policy upheaval. CMS data shows spending surged 40-fold from 2019 to 2024, prompting federal fraud investigations and CMS’s 90% payment cuts. Senator Bill Cassidy (R-LA) introduced the reform bill in July 2025, with a companion House bill following in October.

Between The Lines

Congressional interest is intensifying through behind-the-scenes negotiations rather than formal hearings. Rep. Mariannette Miller-Meeks (R-IA) toured wound treatment facilities, while Rep. Gary Palmer (R-AL) visited an Organogenesis facility. Cassidy framed the current system as enabling "price gouging," citing the need to reduce costs while ensuring patient access.

Competitive Landscape

Acesso operates in a crowded field of wound care companies lobbying on identical issues. ConvaTec retained the same Holland & Knight lobbying team for $80,000 in Q4 2025. Organogenesis spent $300,000 on in-house lobbying in Q3 2025, while bioCARE Donor Tissue Network invested $500,000 through Ballard Partners in early 2025.

The Bottom Line

Acesso is escalating its lobbying push with $420,000 invested across three firms in 2025, specifically targeting the bipartisan payment reform legislation. The timing reflects industry-wide urgency as companies face CMS’s dramatic reimbursement cuts. Multiple manufacturers are lobbying simultaneously on identical issues, suggesting coordinated industry strategy despite intense regulatory pressure on wound care spending.

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