I didn’t write the New York Times article about “skin substitutes” It was written by Sarah Kliff and Katie Thomas. You can send them your comments at nytimes.com/tips.
Jeanne Pinder at Clear Health Costs also has a new article: “Wound Care Regulations Delayed Again, Allowing Questionable Practices to Continue”. She’d love to interview more people about this issue so email her directly at Jeanne@clearhealthcosts.com or encrypted Signal at 914-450-9499.
I DID post redacted messages from various “skin substitute” sales reps telling doctors how much money they can make by using their product. I posted those examples because I am worried that this kind of marketing could be construed as offering a kickback to practitioners. Martha Kelso’s guest blog confirmed that auditors are demanding copies of all marketing materials, which indicates that the auditors are paying close attention to this issue.
As a messenger, I have noted 3 possibly related events:
- Marketing materials from many CTP/skin substitute companies touting huge profits for practitioners using certain skin substitutes.
- National news outlets focused on reported physician profits related to their use.
- Medicare auditors asking to see marketing materials provided to practitioners.
Everyone hates the messenger who brings bad news, but I hope that the message will still be read.
Now that the LCDs are delayed, perhaps we can have a useful conversation about the need for the detailed documentation of good clinician practice to survive Medicare audits, and the door CMS has thrown open for data on clinical effectiveness.
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.
A rouge rep email touting profits should not be confused with approved corporate marketing materials. Auditors have been asking for invoices, purchase agreements and marketing materials since these audits started in 2020. Not new news. Maybe new to you. And definitely not bc auditors are reading your posts. Maybe instead of constantly blaming the manufacturers you should look to your colleagues who only want the expensive grafts and won’t speak to a rep that has “normal” priced graft. On top of that how many providers never pay the graft company and take the money and run. Or when they get audited- try to blackmail the graft company wanting their money back if they did pay- but the providers documentation was no where adequate but blame the graft company for it. Or lastly, file bankruptcy and start new.
You act like something like this has never happened before. Spinal procedures. Ortho. Dermal creams. Tox screening…… Just add this to the list. Once payment is fixed, people will move on to find the next way to exploit a loophole.
There is fault on ALL sides. Not just manufacturers. The LCD addresses clinical not payment. MACs ignore the numerous studies showing all grafts work. Regardless of “brand name” There is nothing stopping these grafts on covered list from increasing ASP 100x. It’s already happening. Watch the July and Oct file. Your so called “good guys” on the covered list with “evidence” is about to milk the system. Fix the way they are paid. LCD does not do that. Allow for fair competition and it will weed out the corrupt MDs and high asps. Something I’m sure most manufacturers actually welcome and want. Stability and a level playing field.
Shoot the messenger? Look in the mirror and look to your colleagues.
KEEP spreading the good word Dr. Fife! Angry sentiment is a reflection of fear and most likely coming from those that are most guilty.
Clearly you know nothing about the issue. Keep your blinders on.
Id be happy to have a conversation with you some how to understand why you feel I have no understanding of the issue at hand – perhaps we could both learn something>?
Dr. Fife. I would like to read the NYT article that you are discussing but I will not pay their registration fees to read it. If there is a way to create a mechanism to dispense the information without incurring a charge and the need to register for a subscription, that would be helpful.
It sounds like the first commentator is implying the messenger should be quiet about the crime because not everybody is committing it? Or maybe because some clinicians are unethical, cheap criminals too?
I am a wound care nurse working in acute care. I have met with legitimate skin graft companies with legitimate marketing and data. I wish I could have advocated to use it for my patients who need it.
But there is reason my hospital said “no deal”. Is that price really “normal”? I don’t know. What’s the markup and profit margin? Biotech and big pharma have a long history….
I also have direct experience with a “rouge reps” touting huge profits during one of the most poorly written marketing presentations I have ever seen, with clearly unsubstantiated “data”.
Later by phone the rep told me he could “get me authorized” and “teach me” how to apply it. Then went on to explain that he “has a doctor” who “could assist me with billing”.
The messenger is speaking the truth. Just sayin