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What Happened to “Innocent Until Proven Guilty? Check Out this Article on Medicare Recoupment

What Happened to “Innocent Until Proven Guilty? Check Out this Article on Medicare Recoupment

by Caroline Fife, M.D. | Mar 19, 2025 | Fight the Good Fight

Check out Knicole Emanuel’s recent blog post about CMS monetary recoupment before full adjudication. The Centers for Medicare and Medicaid Services (CMS) has the authority to recoup alleged overpayments from healthcare providers before the full adjudication of an...
Wound Characteristics Among Patients Exposed to Xylazine

Wound Characteristics Among Patients Exposed to Xylazine

by Caroline Fife, M.D. | Mar 17, 2025 | Fight the Good Fight

An article in JAMA Dermatology reviews the wound characteristics of a series of 29 patients hospitalized with confirmed xylazine exposure. Xylazine was originally developed as a veterinary sedative, anesthetic, and muscle relaxant. Although xylazine is not an opioid,...
GLP-1 RAs and Peripheral Arterial Disease?

GLP-1 RAs and Peripheral Arterial Disease?

by Caroline Fife, M.D. | Mar 14, 2025 | Fight the Good Fight, Obesity & Wound Care

By now I suppose everyone thinks that I am employed by one of the GLP-1RA marketing firms. I have still not decided exactly where to fit this exciting new drug in the armamentarium of a wound care practitioner, but so far the drugs have potential use in just about...
The Alliance of Wound Care Stakeholders’ 2024 Annual Report & Arquillian Battle Cruisers

The Alliance of Wound Care Stakeholders’ 2024 Annual Report & Arquillian Battle Cruisers

by Caroline Fife, M.D. | Mar 5, 2025 | Fight the Good Fight

There’s a line from Men in Black where Agent K says, “There’s always an Arquillian Battle Cruiser, or a Corillian Death Ray, or an intergalactic plague that is about to wipe out all life on this miserable little planet, and the only way these people can get on...
Insurers Continue AI Claims Automation Despite Legal Challenges

Insurers Continue AI Claims Automation Despite Legal Challenges

by Caroline Fife, M.D. | Mar 3, 2025 | Fight the Good Fight

This Modern Healthcare article from 2/26 is behind a paywall, but I am posting the link anyway. The article reports that earlier in February, a federal judge “partially advanced a potential class action lawsuit against UnitedHealth Group and its UnitedHealthcare...
Artificial Intelligence vs Augmented Intelligence in Prior Authorization Denials

Artificial Intelligence vs Augmented Intelligence in Prior Authorization Denials

by Caroline Fife, M.D. | Feb 28, 2025 | Fight the Good Fight

Migraines are the bane of my life, but I’ve gotten relief from Botox injections to trigger points. This was working fantastically for a year, until suddenly my insurance company decided to deny the prior authorization (PA) request. It took six months to get it...
New Taxonomy Codes for Wound Care Practitioners!

New Taxonomy Codes for Wound Care Practitioners!

by Caroline Fife, M.D. | Feb 19, 2025 | Fight the Good Fight

Some of you have alerted me to new taxonomy codes that are relevant to the practice of wound care. This seems like huge news to me! I am listing a few of them below, with some explanation of what the components of the code mean. I do not know, for example, if an...
This Might Be the Worst Flu Season in 15 Years

This Might Be the Worst Flu Season in 15 Years

by Caroline Fife, M.D. | Feb 17, 2025 | Fight the Good Fight, Miscellaneous Musings

The AP (2/7, Stobbe) reported, “The U.S. winter virus season is in full force, and by one measure is the most intense in 15 years.” According to the AP, “one indicator of flu activity is the percentage of doctor’s office visits driven by flu-like symptoms.” Two weeks...
FDA Approves Suzetrigine, a Novel, Non-Opioid Drug for Moderate to Severe Acute Pain

FDA Approves Suzetrigine, a Novel, Non-Opioid Drug for Moderate to Severe Acute Pain

by Caroline Fife, M.D. | Feb 14, 2025 | Fight the Good Fight

On January 30th, the U.S. Food and Drug Administration (FDA) approved Journavx (suzetrigine) 50 milligram oral tablets, a first-in-class non-opioid analgesic, to treat moderate to severe acute pain in adults. Journavx reduces pain by targeting a pain-signaling pathway...
Don’t Miss the Alliance of Wound Care Stakeholders Webinar Feb 12th on the 2025 Medicare Final Rules!

Don’t Miss the Alliance of Wound Care Stakeholders Webinar Feb 12th on the 2025 Medicare Final Rules!

by Caroline Fife, M.D. | Feb 11, 2025 | Fight the Good Fight, Healthcare Payment Policy, Medicare Audits

The Alliance of Wound Care Stakeholders is hosting a webinar on Wednesday, February 12, 2025, 1:00 PM – 2:00 PM EST. If you and your organization provide wound care to Medicare beneficiaries, are you prepared for the important policy updates for 2025 implemented by...
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Wound Care Reimbursements

Recent Articles

  • Skin Substitute / Cellular Tissue Product (CTP) Pricing and a Path Forward November 5, 2025
  • One of Your Letters: UPIC Denies Everything Without Reading the Chart November 3, 2025
  • Breaking news! Cellular Tissue Products (CTPs) / CAMPS to be Paid at $127.28/cm2 November 1, 2025
  • Check Out the Editorial in Med Page Today: 2 Doctors Concerned About Improper Use of Skin Substitutes October 29, 2025
  • The Incredible Journey: Lessons Learned from a “Skin Substitute Graft” Audit – Part One October 28, 2025

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