by Caroline Fife, M.D. | Oct 14, 2026 | Fight the Good Fight
A Walk Down History Lane… and Why We Need Real-World Data As most of you know by now, the CMS Medicare Administrative Contractors (MACs) just released drafts of non-coverage policies for Near-Infrared Spectroscopy (NIRS) in Wound and Flap Management and...
by Caroline Fife, M.D. | Sep 21, 2026 | Fight the Good Fight
Middle District of Tennessee | Brentwood Woman Sentenced to Federal Prison for $6.9 Million Health Care Fraud Scheme | United States Department of Justice Helen Boerman, an optometrist in Brentwood, Tennessee, pleaded guilty to making false, fictitious, or fraudulent...
by Caroline Fife, M.D. | Sep 17, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
The claims alleged by the United States are allegations only. There has been no determination of liability. Heuser Health, a Louisville-based provider of at-home wound care services, has agreed to pay $2,646,186.72 to resolve allegations that it violated the False...
by Caroline Fife, M.D. | Sep 15, 2026 | Fight the Good Fight
Dr. Jay Shah, well-known wound care practitioner and past president of the Texas Medical Association, has a wonderful podcast called, “Let Doctors be Doctors.” In this episode of Let Doctors Be Doctors, Jay talks to another long-time friend of mine, Noel Oliveira, MD...
by Caroline Fife, M.D. | Sep 9, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Dr. Fife – Here’s a new and surprising reason for denial of Medicare payment by Novitas Solutions for amniotic tissue applied to a chronic ulcer. The reason given that the products, “…are for infants and children.” I am providing 2 screen shots from the...
by Caroline Fife, M.D. | Sep 2, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Guest blog by Ryan Mathis On August 26, 2026, the court dismissed the CAMPs Initiative’s second lawsuit challenging the skin substitute reimbursement provisions of the Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) final rule. Just like the first...
by Caroline Fife, M.D. | Aug 31, 2026 | Lymphatic Imaging & Lymphedema
Back to Basics: What We Still Need to Learn, and What We Will Need for the Future More than 25 years ago, I got a call from a woman who introduced herself as an engineer and said, “I hear you have a lot of lymphedema patients.” Boy, did I have a lot of lymphedema...
by Caroline Fife, M.D. | Aug 20, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
The Department of Justice (DOJ) announced an indictment of a Nevada wound care physician for fraud in relation to expensive amniotic allografts. (Note that the conduct described below is alleged. Criminal charges are accusations, not findings of guilt.) The...
by Caroline Fife, M.D. | Aug 10, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
In October 2025, Michael Crouch posted a guest blog about a Medicare audit of skin substitute/CTP claims outlining some very interesting reasons for the denial of charges, including: The products used are amniotic membrane allografts. The amniotic membrane acts as a...
by Caroline Fife, M.D. | Jul 31, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
As Michael Crouch detailed in his 3-part guest blog, Medicare providers under audit may face a lengthy administrative appeals process before obtaining a hearing or review by an Administrative Law Judge (ALJ): The Incredible Journey: Lessons Learned from a “Skin...
