by Caroline Fife, M.D. | Jan 29, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
The delay of the LCD(s) is good news for many manufacturers since it will continue to enable unlimited use of amniotic products, some of which are priced around $5,000 per sq cm. (That’s more than a 3,000% increase in cost with no data to indicate any improvement in...
by Caroline Fife, M.D. | Jan 27, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Check out this article by investigative reporter Jeanne Pinder, CEO of Clear Health Costs, who set out to understand the cost of “skin substitutes.” Caroline Fife, M.D.Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through...
by Caroline Fife, M.D. | Jan 25, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
CMS has indeed delayed the implementation date for the Skin Substitute Grafts/ Cellular and Tissue-Based Products (CTP) for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers LCDs from 2/12/25 to 4/13/25. The policies on the CMS website are now...
by Caroline Fife, M.D. | Jan 23, 2025 | Healthcare Payment Policy
Thank you to HMP for letting me create a video talk on “MIPS (Merit Based Incentive Payment System) Basics”! You can listen to or watch it here on the Today’s Wound Clinic site. An Introduction to MIPS Basics | Today’s Wound Clinic Caroline Fife, M.D.Dr. Fife is...
by Caroline Fife, M.D. | Jan 22, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
There are rumors swirling that President Trump’s Executive Order (EO) which freezes pending federal regulations and guidance documents will stop the implementation of the LCD(s). I have no inside information about this, but the issue is far from certain. The EO...
by Caroline Fife, M.D. | Jan 20, 2025 | Fight the Good Fight, Healthcare Payment Policy
A U.S. District Court in Alabama has given preliminary approval to a landmark antitrust settlement involving Blue Cross Blue Shield (BCBS), calling for the insurer to pay $2.8 billion into a settlement fund designated for settlement class members, including...
by Caroline Fife, M.D. | Jan 17, 2025 | Fight the Good Fight, Obesity & Wound Care
JAMA has published a patient handout explaining the categories of weight loss medications. You have to sign in to download the PDF, but anyone can view it in the link. The need for clinicians of all types to be engaged in conversations with patients about obesity is...
by Caroline Fife, M.D. | Jan 15, 2025 | Fight the Good Fight
Given that the new Local Coverage Determinations (LCDs) on CTPs/skin subs are almost surely going to be implemented on Feb 12th, it’s likely that patients are going to be asked to sign Advanced Beneficiary Notices (ABNs) around their use. I got an interesting email...
by Caroline Fife, M.D. | Jan 13, 2025 | Fight the Good Fight
WHATLEY KALLAS TO HOST WEBINARS FOR HEALTHCARE PROVIDERS ON HOW TO SUBMIT CLAIMS IN THE $2.8 BILLION BCBS ANTITRUST SETTLEMENT – Whatley Kallas Whatley Kallas, LLP, who served as co-lead counsel on behalf of medicine in the recent Blue Cross Blue Shield (BCBS)...
by Caroline Fife, M.D. | Jan 13, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests
The CGS J15 Contractor Medical Directors have given me permission to share the slide deck that was presented on December 20th, which was a training session on the upcoming “skin sub” LCD. This PDF of the slide deck reviews the LCD requirements for the treatment of...
