by Caroline Fife, M.D. | Jun 28, 2024 | Cellular / Tissue-Based Products, 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 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...
by Caroline Fife, M.D. | Jun 14, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
I have blogged a lot about the problems in the CTP/skin substitute industry. If a product is say, 10 times more expensive than another one, then it needs to be 10 times better, right? Otherwise, why is it more expensive? (Pretend that making a profit off of the cost...
by Caroline Fife, M.D. | May 16, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Here’s another perspective on the proposed LCDs. These are excellent discussion points. (I have withheld the author’s name at their request.) –Caroline Pretty much everyone agrees that CMS has a big problem on its hands with “skin substitutes.” This blog and...
by Caroline Fife, M.D. | May 15, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
If you are at [a certain national wound care meeting I won’t name] this week and you missed the email blast below, it may not be too late to have dinner on the Cellular Tissue Product (CTP) company circulating the invitation. Per their email (forwarded to me by...
by Caroline Fife, M.D. | May 3, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
I’ve made no secret of the fact that I’m angry about what appears to be a pattern of overuse and abuse in the Cellular Tissue Product (CTP) / skin substitute industry. In fact, just writing that sentence, I realize my mood is changing. Who wouldn’t be angry about...
by Caroline Fife, M.D. | May 2, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
I got this letter today and have redacted all the identifiers. I’d like to know what people think… Dr. Fife, I am the manager of a hospital-based outpatient wound department (HOPD). We are part of a large healthcare system, and in speaking to my counterparts at...
by Caroline Fife, M.D. | Apr 30, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Healthcare Payment Policy
On April 25, ALL 8 CMS Medicare Administrative Contractors (MACs) released proposed LCD/LCAs for Skin Substitutes/CTPs for DFUs and VLUs. I have already mentioned the fact that the proposed policy sets a limit of 4 CTP applications per year (although additional...
by Caroline Fife, M.D. | Apr 26, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Yesterday morning, 8 MACs issued nearly identical draft coverage policies for the use of CTPs (“skin subs”) in diabetic foot ulcers and venous leg ulcers. (Note that the policy does not apply to pressure ulcers/injuries). In addition to the exhaustive documentation...
by Caroline Fife, M.D. | Apr 11, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
I am trying to find ways to visually depict our current situation with regard to Cellular and/or Tissue-based products (CTPs). Several things can be true at once: Package pricing in the hospital-based outpatient department (HOPD) limits the cost per PIECE that a...
