by Caroline Fife, M.D. | Jul 11, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
The Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the 2025 Medicare physician fee schedule (PFS). The big question in our field was whether CMS would start “package pricing” CTPs/skin subs in the physician office. They didn’t –...
by Caroline Fife, M.D. | Jul 10, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
The Outpatient Prospective Payment System (OPPS) proposed rule has come out! It will take time to read and digest so details will follow. At first glance, there are no changes to Cellular Tissue Product /skin substitute payment, which remain under package pricing in...
by Caroline Fife, M.D. | Jul 9, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
I am trying to understand the mechanics of the way that practitioners make money off the CTP/skin sub itself. In principle it sounds straightforward, but in reality, “it’s complicated.” A clinician sent me these 2 invoices for the same amniotic product applied in the...
by Caroline Fife, M.D. | Jul 8, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Sadly, it appears that the CTP/skin sub industry has become a game, the goal of which is to fleece Medicare. You can argue that this is not so (and I’d love to get a respectfully worded message or email from you with your thoughts!), but it looks that way to me–...
by Caroline Fife, M.D. | Jul 5, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Politico released an article about the billion dollar scam of “skin substitutes.” It’s behind a pay wall, so I will summarize the key points. (I will use the term “skin substitutes” since that’s how they are referred to in the Politico article.) Since I started...
by Caroline Fife, M.D. | Jul 3, 2024 | Miscellaneous Musings
July 4th is my favorite holiday. I admit that a big reason is that I am a sucker for fireworks. However, the main reason that I love the 4th of July is that I love America. In an era that denigrates patriotism, at least on July 4th it is possible to revel in patriotic...
by Caroline Fife, M.D. | Jul 1, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
I have posted blogs about the fact that the pricing of skin subs is continuously escalating. There are amniotic products out there now which are more than $3,000 cm2, and there is ZERO data to suggest that they are any better than amniotic products 100 times cheaper....
by Caroline Fife, M.D. | Jun 28, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
Yesterday (June 27th) the Department of Justice (DOJ) announced that the two wound care company owners have been accused of accepting more than $330 million in kickbacks as part of a scheme to fraudulently bill Medicare for amniotic grafts. The report states that more...
by Caroline Fife, M.D. | Jun 27, 2024 | Nutrition & Wound Healing
In a recent study published in the New England Journal of Medicine, Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity, Tirzepatide (the medication in the weight-loss drug Zepbound and also the diabetes treatment Mounjaro), appeared to reduce the...
by Caroline Fife, M.D. | Jun 26, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
How much do you think that price impacts the way that CTPs (skin subs) are selected in the office setting? One reader sent me this thought – which is testable statistically (although I do not have access to the data to do it): “Dr. Fife, I could be wrong, but I think...
