by Caroline Fife, M.D. | Apr 9, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight, Healthcare Payment Policy
United Healthcare has updated its Skin and Soft Tissue Substitutes policy effective May 1, 2024, which details the coverage and documentation criteria specifically for EpiFix or Grafix® (GrafixPL, GrafixPRIME and GrafixPL PRIME) (Non-Injectable). The policy also...
by Caroline Fife, M.D. | Mar 27, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
Where will this end? Caroline Fife, M.D.Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel...
by Caroline Fife, M.D. | Mar 25, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
I’ve posted previous blogs detailing what I’ve learned about the impact of establishing the Average Sales Price (ASP) for products, and the perverse impact that an established ASP seems to have. Here’s a visual example of the insanity of pricing and the problem with...
by Caroline Fife, M.D. | Mar 21, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Last week I attended the inaugural Cellular, Acellular, and Matrix-like Product (CAMP) Summit. It was a very interesting and well-run meeting. I will digress to mention the acronym “CAMP” which is gaining traction over the more awkward (and possibly obsolete) Cellular...
by Caroline Fife, M.D. | Mar 19, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight, Healthcare Payment Policy
Five months ago, I posted a blog about the Centers for Medicare and Medicaid Services (CMS) posting special instructions on how to submit a claim for CTP/skin subs that was $100,000 or more. I was horrified. By way of background, you need to know that one of the...
by Caroline Fife, M.D. | Mar 15, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes
A friend sent me this email from a Cellular Tissue Product (CTP) / skin substitute rep. The comments/questions in the green boxes are mine. I ran out of words a long time ago. Message me if you have any words. (In the “cost measure” piloted by CMS, according to my...
by Caroline Fife, M.D. | Jan 23, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Medicare updates compared to inflation chart (Cumulative) (ama-assn.org) Physicians’ Medicare payments were cut 3.37% on Jan. 1, 2024, on top of a 2% cut that that occurred last year. In total, Medicare physician pay has fallen 26% since 2001 (inflation-adjusted...
by Caroline Fife, M.D. | Jan 19, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Many thanks to Sharon Hannan, Executive VP of Integumetrix, for her insightful reaction to this article. –Caroline Dr. Fife, As a previous Director of Wound and HBO services at a major hospital system, I can attest to the inaccuracies of hospital financial data...
by Caroline Fife, M.D. | Dec 27, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
JAMA just released an editorial about the impact of greed on the US healthcare system. I want to be very clear about the fact that I am devoted to the free market. If history and human psychology teach us anything, it is the value of a free market economy. With the...
by Caroline Fife, M.D. | Dec 20, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Dear Dr. Fife, I thought people should understand what happens to doctors who play by the rules when it comes to the use of Cellular Tissue-Based Products / Skin Substitutes in their private office. Here’s a spreadsheet explaining what happens to my practice (office...
