by Caroline Fife, M.D. | Jul 7, 2025 | Medicare Audits
CMS says scammers are sending Medicare providers and suppliers phishing fax requests for medical records and documentation, falsely claiming to be part of a Medicare audit. This notice was posted on the CMS website: “CMS has identified a fraud scheme targeting...
by Caroline Fife, M.D. | Mar 28, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Welcome to the Circus: The State of Healthcare in America | medicaidlaw-nc Attorney Knicole Emanuel has another blog post (yes, I am a big fan of her blog) about Medicare audits. She describes “compliance” as a “Kafkaesque masterpiece of government regulation.” The...
by Caroline Fife, M.D. | Mar 24, 2025 | Medicare Audits
Here’s a guest blog from Michael Crouch, following up on Martha Kelso’s post about audit requirements. I hope the information from these industry experts will help practitioners prepare themselves better for the audits that are bound to happen. If you have been...
by Caroline Fife, M.D. | Mar 18, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Medicare Audits
Here’s a guest blog from Martha Kelso, Chief Regulatory Officer at Wound Care Plus, LLC, providing a heads-up about the documentation demands for her most recent audit of CTPs/CAMPs/skin substitutes – this time a UPIC audit. According to the Medicare Program Integrity...
by Caroline Fife, M.D. | Feb 26, 2025 | Medicare Audits
Here’s another fantastic post from attorney Knicole Emanuel about the serious overreach problems inside the alphabet soup of Medicare audits. This is an issue that will get even more problematic due to the delay of the “skin substitute” LCD(s). Some auditors are...
by Caroline Fife, M.D. | Nov 18, 2024 | Fight the Good Fight
Attorney Knicole Emanuel recently blogged about Medicare audits. It’s a good news/bad news story. The good news is that a physician who was determined by an auditor to have been “over paid” by $5 million ended up owing NOTHING. The bad news is that the cost of taking...
by Caroline Fife, M.D. | Sep 9, 2024 | Healthcare Payment Policy, Medicare Audits
I have been posting warnings about the increase in Medicare audits, especially for CTPs/skin subs and hyperbaric oxygen therapy for many years. Because everyone was being audited, I KNEW that my hospital-based outpatient department (HOPD) was going to be audited. The...
by Caroline Fife, M.D. | Feb 29, 2024 | Fight the Good Fight
I am a huge fan of attorney Knicole Emanuel’s blog and her most recent post is directly relevant to the field of wound care. Check out what she has to say about the anticipated increase in Medicare audit activity around pneumonic compression devices (PCDs). In the...
by Caroline Fife, M.D. | Nov 20, 2023 | Fight the Good Fight, Medicare Audits
This is part of my series of articles about Useful Information on Medicare Audits. Palmetto is the MAC for: Region J: Alabama, Georgia, Tennessee (Region J) Region M: North Carolina, South Carolina, Virginia, West Virginia (excludes Part B for the counties of...
by Caroline Fife, M.D. | Oct 31, 2023 | Fight the Good Fight, Medicare Audits
This is part of my series of articles about Useful Information on Medicare Audits. Palmetto is the MAC for: Region J: Alabama, Georgia, Tennessee (Region J) Region M: North Carolina, South Carolina, Virginia, West Virginia (excludes Part B for the counties of...
