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...
by Caroline Fife, M.D. | Jul 29, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Subscribers to CMS (Centers for Medicare and Medicaid Services) listservs recently got a very short email announcing that CMS is reopening the call for clinical evidence on skin substitutes. I’d provide a link to the bulletin – but there isn’t one! It was simply...
by Caroline Fife, M.D. | Jul 22, 2026 | Fight the Good Fight
The Physician Fee Schedule proposed rule is out. Remember that like the OPPS proposed rule, there’s a comment period and possible changes before this is finalized. Here are the links you need to read things yourself. CMS is inviting comments on all these proposals and...
by Caroline Fife, M.D. | Jul 20, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
The Subcommittee on Health Care and Financial Services Chairman Glenn Grothman (R-Wis.) announced a roundtable on “Medicare Fraud: Examining the Explosive Growth in Skin Substitute Spending”. DATE: Tuesday, July 21, 2026 TIME: 2:00p.m. ET LOCATION: 2154 Rayburn...
by Caroline Fife, M.D. | Jul 17, 2026 | Medicare Audits
I have gotten quite a few emails and calls from readers (and their attorneys) about audits focused on skin subs and debridements. Many practitioners simply do not have sufficient documentation to defend the denied claims and honestly, there’s...
by Caroline Fife, M.D. | Jul 15, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
Since 2022, federal prosecutors have brought an escalating wave of civil and criminal actions targeting skin substitute (cellular and/or tissue-based product, or “CTP”) billing — from single-clinic settlements to the billion-dollar amniotic allograft...
by Caroline Fife, M.D. | Jul 9, 2026 | Nutrition & Wound Healing, Obesity & Wound Care
Since most patients with chronic non-healing wounds are obese, I have been watching the “GLP-1 revolution” with interest. I have described the hopeless feeling of seeing one obese patient after another with chronic wounds (some of whom fall asleep while you are...
by Caroline Fife, M.D. | Jul 7, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
–The legal fight over how Medicare pays for skin substitutes is back in court! Here’s a guest blog by Dr. Ryan Mathis to explain it. Caroline On June 22, 2026, the CAMPs Initiative refiled its lawsuit challenging the skin substitute reimbursement provisions of...
by Caroline Fife, M.D. | Jul 6, 2026 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Just in time for the 4th of July holiday! CMS just released the Hospital Outpatient Prospective Payment proposed rule! There was no change to the skin subsitute payment rate in OPPS. The Physician Fee Schedule proposed rule will be out shortly, but CMS already seems...
by Caroline Fife, M.D. | Jun 24, 2026 | Data-Driven Wound Care
“Wounds” has just released The Wound Care Collaborative Community’s (WCCC) proposed addendum to the now 20 year old Food and Drug Administration (FDA) Guidance document on chronic wounds. The 2006 FDA guidance predates two decades of scientific progress, so the WCCC...
