by Caroline Fife, M.D. | Jun 27, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitute Arrests, CTP / Skin Substitutes
The Houston Chronicle has reported that a Houston podiatrist and his business partner have been charged with $45 million in healthcare fraud in relation to the billing of bioengineered skin substitutes Dr. David Jenson and Nestor Refael Romero Magallanes are...
by Caroline Fife, M.D. | Jun 25, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
An article by SmartTRAK shows that Cellular Tissue Products (CTPs) / Skin Substitutes in the Physician Office and Mobile environment grew by over $5 Billion between 2021 and 2024 compared to only $1 Billion in all other care settings combined. The U.S. CTP/skin...
by Caroline Fife, M.D. | Jun 23, 2025 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers
Dear Dr. Fife, I am writing this letter as a general surgeon who is deeply concerned about our healthcare system. As you have pointed out in your blog, physician payments by CMS and private insurers are a fraction of what they were 20 years ago because physician...
by Caroline Fife, M.D. | Jun 20, 2025 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers
The National Quality Forum (NQF) has issued a request for public comment about their update on Serious Reportable Events (SREs). Every hospital-based outpatient wound center (HOPD) and “mobile” wound care practitioner needs to read this carefully. I hope all of you...
by Caroline Fife, M.D. | Jun 16, 2025 | Fight the Good Fight
I hear the most interesting things about when Medicare rules apply and about the requirements of the Merit-Based Incentive Payment System (MIPS). For example, two years ago, a doctor whose practice involved the application of CTPs/skin substitutes on patients in the...
by Caroline Fife, M.D. | Jun 13, 2025 | Fight the Good Fight
I had a great time talking to Elizabeth Anderson of SmartTRAK about what the real world analysis of diabetic foot ulcer and venous leg ulcer patients revealed, including the astounding similarity of their underlying medical conditions and medications. The prevalence...
by Caroline Fife, M.D. | Jun 11, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
I got this letter from a Physical Therapist, and I am publishing it anonymously with his permission. –Caroline Dear Dr. Fife, I am a physical therapist (PT) specializing in wound care. A PT acquaintance of mine has partnered with a Nurse Practitioner (PT) in a...
by Caroline Fife, M.D. | Jun 9, 2025 | Fight the Good Fight
HHS-OIG identified $1.3 billion in potential savings if #Medicare reimbursed provider-based facilities at the non-facility rate. Related reports include recommendations for legislative action and areas where congressional oversight may be warranted. See also: Site...
by Caroline Fife, M.D. | Jun 6, 2025 | Healthcare Payment Policy
A 2022 study in JAMA Association found that the Quality Payment Program (QPP) was “approximately as effective as chance in terms of identifying high versus low quality performance.” That’s a big “oops” when you can lose up to 9% of your Medicare billing based on your...
by Caroline Fife, M.D. | Jun 5, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight, Healthcare Payment Policy
There’s a new article in Health Affairs about “site neutral” payments that could change everything for hospital-based outpatient departments – and by that, I mean, possibly end them. However, I have been wrong about this threat for more than a decade – which means...
