by Caroline Fife, M.D. | Nov 5, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Do the Right Thing: Thoughts on Quality
Months ago, Medicare announced its intention to change the payment model for CTP/CAMPs and create a fixed payment rate of around $125/cm2. Many thought that the proposed payment rate would be increased substantially in response to Congressional lobbying. These efforts...
by Caroline Fife, M.D. | Nov 3, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Hi Caroline, I just read the great article by Mike Crouch on the UPIC audits around skin substitutes. We’re looking at a UPIC denial for a patient we successfully grafted last year. They claim we had no weekly measurements! Absurd!! They said we don’t measure wounds...
by Caroline Fife, M.D. | Nov 1, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Breaking news! Physician fee schedule finalized-CTPs/CAMPS priced at ~ $127.28/cm2. Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F) More information to come – stay tuned! Caroline Fife Caroline Fife, M.D.Dr. Fife is a world...
by Caroline Fife, M.D. | Oct 29, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
On October 8th, Med Page Today published an opinion piece by physicians Thomas Lally and Michael Millie about the increasing use of skin substitutes in chronic wounds. Their independent medical group cares for more than 100,000 seniors across 17 states, which...
by Caroline Fife, M.D. | Oct 28, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Guest Blog by Michael J. Crouch, CPC, CPMA, CHT-ADMIN Dr. Fife – In March, I provided feedback on a skin substitute graft (SSG) audit in which I was involved that was similar to the one Martha Kelso described. The Unified Program Integrity Contractor (UPIC)...
by Caroline Fife, M.D. | Oct 27, 2025 | Fight the Good Fight, Obesity & Wound Care
I know by now everyone must think that I secretly work for one of the pharmaceutical companies that sells GLP-1-RAs but honestly, I am just a fascinated spectator. Obesity and its related diseases are a major contributor to the chronic wound epidemic and after more...
by Caroline Fife, M.D. | Oct 22, 2025 | Fight the Good Fight, Obesity & Wound Care
Dr. Fife, Surprise! When industry changes the definition of obesity, they find more obesity! We needed something better than the BMI, but this is not the solution. If Waist:Hip ratio is used, the goal should not be “ideal for young people” because it is...
by Caroline Fife, M.D. | Oct 20, 2025 | Fight the Good Fight, Obesity & Wound Care
I don’t know if this is good news or bad news, but the American population just got fatter thanks to a new definition of obesity in a study published in JAMA Open Network. If you are a “glass half full” sort of person, then the new definition might make it easier to...
by Caroline Fife, M.D. | Oct 16, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
Alexandra Gehrke and her husband, Jeffrey King of Arizona pleaded guilty to over $1.2 billion of false and fraudulent Medicare and other insurance claims for, “expensive, medically unnecessary wound grafts that were applied to elderly and terminally ill patients.” The...
by Caroline Fife, M.D. | Oct 13, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
Eastern District of California | Fresno County Podiatrist and Sales Representative Plead Guilty to Conspiracy to Submit False Claims Related to Skin Grafts | United States Department of Justice US Attorney Eric Grant has announced that Felipe Ruiz, a podiatrist at...
