by Caroline Fife, M.D. | Jan 5, 2021 | Healthcare Payment Policy
Dr. Helen Gelly sent me the statement below from Blue Cross Blue Shield of Alabama (BCBSAL) as it pertains to considerations regarding Hyperbaric Oxygen Therapy: Menstruation: There is a great risk for decompression illness in the early phase of the menstrual cycle....
by Caroline Fife, M.D. | Dec 16, 2020 | Healthcare Payment Policy
It’s time to revisit the issue of the relationship of the physician to the hospital-based outpatient department (HOPD), the “site of service” for many wound care programs. The issue is confusing, I agree. More and more wound management is being done in doctor’s...
by Caroline Fife, M.D. | Dec 10, 2020 | Healthcare Payment Policy, Quality Payment Program
Here are links to information regarding the Physicians Fee Schedule final rule: Final Rule Physician Fee Schedule Final Rule fact sheet Quality Payment Program Final Rule fact sheet and FAQs Here are the Physician Fee Schedule files:...
by Caroline Fife, M.D. | Dec 9, 2020 | Healthcare Payment Policy, Quality Payment Program
CMS is conducting Webinars on the Final Rules of the Quality Payment Program and the Physician Schedule – starting today! 1. Register for the December 9 Overview of the 2021 Quality Payment Program Final Rule Webinar 2:00 – 3:30 pm eastern The Centers for...
by Caroline Fife, M.D. | Dec 8, 2020 | Do the Right Thing: Thoughts on Quality, Fight the Good Fight, Healthcare Payment Policy
I understand why companies develop products for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs), even though those are NOT the most common wound problems. It’s because the clinical trials needed to satisfy the Food and Drug Administration (FDA) are well...
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...
