by Caroline Fife, M.D. | Oct 12, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Check out the entire series here. In 2015, CMS moved to “package pricing” for CTPs/skin subs in the hospital-based outpatient clinic. When that happened, the cost of the product was incorporated into the charge for the visit, and that caused a sudden and dramatic...
by Caroline Fife, M.D. | Oct 10, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Check out the entire series here. Here’s another message that I agreed to post anonymously that asks many questions we are asking: Why are two products made in the same tissue lab and identical as far as any of us can tell, priced completely differently, with one of...
by Caroline Fife, M.D. | Oct 9, 2023 | Fight the Good Fight, Lymphatic Imaging & Lymphedema
There is increasing awareness that not only does chronic illness negatively impact mental health, but that conditions like depression negatively impact the effectiveness of treatment! Many thanks to Eric Ansart for reminding us about the impact of lymphedema on mental...
by Caroline Fife, M.D. | Oct 9, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Check out the entire series here. Dr. Fife, I thought you should see this advertisement for “research” with CTPs/skin subs. It’s not an isolated case. Many of them are doing this where the MACs have cracked down on Rebate programs, particularly in nursing...
by Caroline Fife, M.D. | Oct 4, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Check out the entire series here. This morning I got an email from a friend and colleague who is one of the best and most ethical wound care practitioners that I know. His letter below points out the problem that started this mess, which is the methodology behind...
by Caroline Fife, M.D. | Oct 2, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
I know there is widespread celebration over the fact that 3 MACs have rescinded their Local Coverage Determinations (LCDs) for CTPs/skin subs. There’s no question that there were a LOT of problems with those LCDs. However, the MACs are attempting to manage bad...
by Caroline Fife, M.D. | Sep 29, 2023 | Fight the Good Fight, Medicare Audits
I’ve been publishing a series of articles about Useful Information on Medicare Audits. First Coast is the MAC for Florida, Puerto Rico, U.S. Virgin Islands. Here’s the checklist First Coast used for a Targeted Probe and Educate (TPE) audit. Checklist looks the...
by Caroline Fife, M.D. | Sep 28, 2023 | Fight the Good Fight
This morning, three Medicare Administrative Contractors (MACs) Novitas, CGS Administrators, and First Coast Service Options, published updates to their local coverage determinations (LCDs) on “Skin Substitute Grafts/Cellular and/or Tissue-Based Products,”...
by Caroline Fife, M.D. | Sep 28, 2023 | Fight the Good Fight, Medicare Audits
Clinicians sometimes email me about Medicare audits that they are undergoing. Since nearly everyone is being audited on either hyperbaric oxygen therapy (HBOT), the use of “skin subs” – properly known as Cellular and/or tissue-based products (CTPs) — or...
by Caroline Fife, M.D. | Sep 14, 2023 | Fight the Good Fight
Twenty years ago, my husband, a busy Ob/Gyn, reached the point that he was not able to pay his malpractice premium (six figures) and his office staff – much less take home any income. One evening we discussed whether he was going to have to quit practicing Obstetrics...