I know there is widespread celebration over the fact that 3 MACs have rescinded their Local Coverage Determinations (LCDs) for CTPs/skin subs. There’s no question that there were a LOT of problems with those LCDs. However, the MACs are attempting to manage bad behavior by practitioners with the blunt tools at their disposal. The MACs and CMS WILL have to create limits on utilization because there IS a problem with abuse and overuse. If we do not talk about these problems – if we keep pretending that there is nothing wrong out there – then ultimately CMS and its contractors will “fix it.” And so will the OIG.

If you think I am making this up, look at these examples of advertisements to practitioners. I am not showing the name of the company.

I know the photo is grainy so let me tell you what it says:

“NO invoice for billing”

“$800 per square cm, Reimbursement $1,338 per square cm”

I am curious how is it possible to make profits like this off the PRODUCT itself? Why isn’t an invoice needed? AM I THE ONLY ONE WHO THINKS THERE IS SOMETHING WRONG HERE?

Here’s another one.

I know it’s blurry, but here are the numbers:

Does anyone want to talk about what this table means?

Feel free to send me the ads that you have seen. I will redact the name of the company and post them.

And to make this more fun, watch out for a new series on my blog called, “Confessions of a Skin Sub rep.”


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