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...
by Caroline Fife, M.D. | Jun 4, 2025 | Fight the Good Fight
Dr. Jay Shah is a well-known wound care practitioner, and he is now the President of the Texas Medical Association (TMA). Being active in organized medicine is a sacrifice. I am grateful and excited that a wound care practitioner holds a position of such influence!...
by Caroline Fife, M.D. | Jun 2, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
I had a great time speaking at the WOCN conference in Orlando! I was asked to provide an update on “Skin Substitutes.” I will give you a few highlights from the talk. I reviewed the reasons we need skin substitutes, such as the huge percentage of patients suffering...
by Caroline Fife, M.D. | May 30, 2025 | Healthcare Payment Policy
I know you love reading about the Merit Based Incentive Payment System (MIPS) as much as I love writing about it… However, MIPS now matters to a lot more practitioners as wound care transitions into the office-based/mobile setting. (I will make a mental note to...
by Caroline Fife, M.D. | May 28, 2025 | Fight the Good Fight, SAWC
At the recent SAWC, the Alliance of Wound Care Stakeholders hosted Dr. Anitra Graves, the Medical Director for First Coast. Dr. Graves gave a fantastic presentation on the use of real-world data in Medicare coverage policy. I thought I’d provide some of the notes that...
by Caroline Fife, M.D. | May 21, 2025 | Fight the Good Fight, If I Were Queen
In the 30+ years I’ve been taking care of patients with chronic wounds, I’ve given a lot of thought to the things that are covered by Medicare and other payers (some of which, frankly, don’t work very well) vs. the things that are NOT covered, but work...
by Caroline Fife, M.D. | May 19, 2025 | Pyoderma Gangrenosum
I felt guilty the day I decided I could no longer prescribe opioid pain medications to patients with severely painful wounds. I didn’t prescribe narcotics very often since that’s a bad way to treat any chronic pain, but it is sometimes necessary in acute vasculitis...
by Caroline Fife, M.D. | May 16, 2025 | Fight the Good Fight
This week, the Head of the Justice Department’s Criminal Division, Matthew R. Galeotti, delivered remarks at an Anti-Money Laundering and Financial Crimes Conference, announcing that the DOJ’s Criminal Division was “turning a new page on white-collar and corporate...
