by Caroline Fife, M.D. | Dec 7, 2020 | Healthcare Payment Policy
It happened again. Someone asked me if it was possible to use real world data for a comparative effectiveness study in wound care. There was a fantastic presentation on this topic given in 2016 at ISPOR (the International Society for Pharmacoeconomics and Outcomes...
by Caroline Fife, M.D. | Dec 2, 2020 | Healthcare Payment Policy, Quality Payment Program
Deadlines are approaching for Physicians to submit hardship exemption paperwork to CMS. Depending on your situation, requesting an exemption could spare you penalties under MIPS. I will be the first to admit that this process is darn confusing when it’s business as...
by Caroline Fife, M.D. | Nov 20, 2020 | COVID-19, Healthcare Payment Policy
As a result of the pandemic, The Centers for Medicare and Medicaid Services (CMS) has invoked its Extreme and Uncontrollable Circumstances policy (click the link to download the PDF) and is allowing participants in the Merit Based Incentive Payment System (MIPS) to...
by Caroline Fife, M.D. | Nov 12, 2020 | Healthcare Payment Policy
Thank you to Dr. Helen Gelly for providing this guest post about Medicare denials for radiation proctitis. –Caroline Why are Medicare charges for hyperbaric oxygen therapy (HBOT) denied when treating radiation proctitis? National Coverage Decision (NCD) 20.29...
by Caroline Fife, M.D. | Nov 6, 2020 | Healthcare Payment Policy
Recently someone asked me if it was actually possible to report wound care relevant quality measures to CMS as part of MIPS (the Merit Based Incentive Payment Plan). The answer is yes. Here are screenshots from my own reporting, so you can see that I reported them and...
by Caroline Fife, M.D. | Oct 20, 2020 | Fight the Good Fight, Healthcare Payment Policy
The Undersea and Hyperbaric Medical Society (UHMS) Gulf Coast chapter meeting is available now on the UHMS CME portal. It includes a talk I gave on whether a registry could save the field of Hyperbaric Oxygen Therapy (HBOT). I became committed to the need for a...
by Caroline Fife, M.D. | Oct 6, 2020 | Healthcare Payment Policy
As we’ve discussed previously, the Centers for Medicare and Medicaid Services (CMS) reclassified all services in the Hospital-Based Outpatient Department (HOPD) under “general supervision” away from “direct supervision,” with the caveat that it was up to the...
by Caroline Fife, M.D. | Sep 15, 2020 | Healthcare Payment Policy
I got my 2019 MIPS (Merit Based Incentive Payment System) Final Score Report. I reported wound care relevant measures in 2019 and got high quality scores. Check out my Diabetic foot ulcer (DFU) healing rate. It was 33.14% – and yet I still scored 8.39/10 with...
by Caroline Fife, M.D. | Sep 10, 2020 | Healthcare Payment Policy
The Congressional Budget Office (CBO) has issued the report below, estimating that the Medicare Trust Fund will become insolvent in 2024, two years sooner than the previous estimate, because of the pandemic. The Medicare Payment Advisory Commission (MedPAC) members...
by Caroline Fife, M.D. | Sep 9, 2020 | Healthcare Payment Policy
Novitas and First Coast have retired their Local Coverage Determinations (LCDs) for Hyperbaric Oxygen Therapy (HBOT). Because the National Coverage Determination (NCD) for HBOT remains in place, theoretically coverage for HBOT should not change as a result. At least...
