by Caroline Fife, M.D. | Aug 27, 2025 | Fight the Good Fight
The Office of Inspector General (OIG) is part of the U.S. Department of Health and Human Services (HHS) and serves as the internal watchdog for HHS programs like Medicare and Medicaid. The OIG’s job is to monitor compliance with Medicare/Medicaid billing rules. The...
by Caroline Fife, M.D. | Aug 26, 2025 | Fight the Good Fight
Hi Dr. Fife, Thank you for your interesting and timely blog posts. My husband and I read the one about the Do-It-Yourself Hearing Test with interest. Unfortunately, our iPhones and AirPods are a little too old to use the Hearing Aid option. However, in case there are...
by Caroline Fife, M.D. | Aug 21, 2025 | Fight the Good Fight
I can’t believe that it’s been 20 years since I had idiopathic sudden sensorineural hearing loss (ISSHL). I had been lecturing nearly all day to a group of physicians and naturally, it was Friday afternoon when I finished my last talk. When people came up to chat with...
by Caroline Fife, M.D. | Aug 19, 2025 | Fight the Good Fight
“You can’t fall asleep while I am talking to you unless we are married.” That’s what I say to all the patients who fall asleep in the exam room. It seemed humorous at first, until I realized that sleep apnea could be the reason that some patients were not healing....
by Caroline Fife, M.D. | Aug 14, 2025 | Fight the Good Fight, Healthcare Payment Policy
White House, Tech Leaders Commit to Create Patient-Centric Healthcare Ecosystem | CMS Health Technology Ecosystem | CMS “For decades, bureaucrats and entrenched interests buried health data and blocked patients from taking control of their health,” said HHS Secretary...
by Caroline Fife, M.D. | Jul 30, 2025 | Fight the Good Fight, Healthcare Payment Policy
I should leave the coverage interpretation to the professionals. I appreciate all of you who tell me when I make a mistake. Donna Cartwright — who is a genuine expert — provided corrections on that UHC policy: “Epifix and Grafix are the only amniotic...
by Caroline Fife, M.D. | Jul 9, 2025 | Fight the Good Fight, Healthcare Payment Policy
CMS has released Quality Payment Program (QPP) performance data for 2023. Under the QPP, payment “adjustments” (bonuses and penalties) occur two years after the “performance year,” so that 2023 scores impact a practitioner’s 2025 Medicare payments. It’s important to...
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...
