Cellular / Tissue-Based Products (CTPs)
Price & Size Limits to Cellular Tissue Product (CTP) Use in the HOPD vs the Office (This is All So Messed Up)
I am trying to find ways to visually depict our current situation with regard to Cellular and/or Tissue-based products (CTPs).
United Healthcare Updates its Skin and Soft Tissue Substitutes Policy Detailing Coverage for Epifix and Grafix® (and Listing the Products They Won’t Cover)
The policy also includes an extensive list of products that will NOT be covered by United Healthcare.
An Offer You Can’t Refuse? “A 4×4 Would Generate a Little Over $20,000 for Your Practice.”
Where will this end?
Pricing Trends in Cellular Tissue Products (CTPs) / Skin Substitutes / CAMPs – and Why Publishing the ASP is Not Helping
Here’s a visual example of the insanity of Cellular Tissue Product (CTP) pricing and the problem with ASPs.
Algorithm for Selection a “CAMP”: Ideal vs. Real
Last week I attended the inaugural Cellular, Acellular, and Matrix-like Product (CAMP) Summit. It was a very interesting and well-run meeting. I will digress to mention the acronym “CAMP” which is...
It’s Finally Happened – CMS Has Issued Instructions on How to Bill a Claim for $99,999,999,99
I need to know how to justify putting one skin substitute on a patient that is 100 times more expensive than another one.
It’s Happened – a Cellular Tissue Product (CTP) / Skin Substitute That is >$2,800 per cm2
A friend sent me this email from a Cellular Tissue Product (CTP) / skin substitute rep. I ran out of words a long time ago. Message me if you have any words.
The January 1st Physician Pay Cut & Unintended Consequences
Many physicians are either leaving practice or making the difficult decision to stop seeing Medicare patients.
Reaction: Why Hospital Cost Reporting is a Mess
Many thanks to Sharon Hannan, Executive VP of Integumetrix, for her insightful reaction to our “Package Pricing” article.
Salve Lucrum: The Existential Threat of Greed in US Healthcare – and Some Thoughts About Cellular Tissue Products (CTP’s) / Skin Substitutes
I have to agree with the final sentence of this article: Healthcare should not be an engine for excessive private gain.
How Playing by the Rules with Cellular Tissue-Based Products / Skin Substitutes Can LOSE Money in the Doctor’s Office
I thought people should understand what happens to doctors who play by the rules when it comes to the use of CTP/skin subs in their private office.
Thoughts on How to Fix the Cellular Tissue Product (CTP) / Skin Substitute Crisis
We’ve spent a lot of time talking about what is broken, now is the time to collaborate in a positive way about how to make it better.
Big Profits in Medicare Patients Only!
The Medicare trust fund is bankrupt and this “profit” is funded by our tax dollars. How does that make you feel?
Alliance Advisory Panel Recommendations to CMS to Help With the Skin Substitute / Cellular-Based Tissue Products Problems
If you have other ideas that might address the long list of problems identified so far, feel free to send them to me.
Selling the Spread on Cellular Tissue Products (CTP’s) / Skin Substitutes – is That Even Legal?
I am told that this case is cited in training programs for pharmaceutical sales reps to highlight the fact that “Selling the Spread” is a violation of Federal law etc.
Taking a Closer Look at the OIG Report on “Skin substitute” (CTP) ASP Transparency
You should read the whole report (it’s not very long), but I am going to provide some excerpts.
A Different Level of Thinking on Cellular Tissue Product Skin Substitute Policy
I previously posted the list of issues as I see them in this industry. Now I’d like to create a list of the attributes of a good solution.
A Problem Well-Stated is a Problem Half Solved… (Hopefully)
. If CMS or the MACs try to “fix” the situation without input from us, we have seen how unfortunate the results can be.
(Not) Choosing Wisely for Cellular and/or Tissue-Based Products (CTPs)
We could figure this out if we wanted to, but right now there’s so much money to be made that it’s an uphill battle.
Be a Wound Care Millionaire with 25 Patients or Less – and Maybe Lose it All in a RAC Audit?
A physician who is a walking saint with regard to clinical practice, but whose documentation failed in one subjective area, could end up paying back a small fortune.
How to Submit a Medicare Claim for a CTP When the Dollar Amount Exceeds $99,999.99
…with a question about the per cm sq price variations for Cellular / Tissue-Based Products (CTPs).
$180,000 for In-Home Application of Cellular / Tissue-Based Products (CTPs)… I Have Run Out of Words for This
I could provide the names of the companies involved, but I can’t afford the legal bills.
Disparities in Access to Care for CTPs / Skin Subs (and How Package Pricing in the Doctor’s Office Might Actually Improve Access to Them)
Everywhere I turn, there seems to be an issue that is ethically worrisome about Cellular / Tissue Based Products (CTPs).
Wound Care, the “Rodney Dangerfield” of Specialties – At Least Partly Due to the CTP Payment Methodology
Do you think that the [current CTP payment system] supports thoughtful patient care and the medically appropriate use of CTPs in the physician’s office?
More of Your Letters: Skin Substitutes, CMS, Failed Proposals and the Broken System
Here’s another message that I agreed to post anonymously that asks many questions we are asking.
“Research Not Rebates”… and “Our IRB Status with the Department of Health and Human Services…” Hmmmmmm……..
I worry that this is a thinly disguised rebate program, and it would be a shame if that approach backfires on legitimate research initiatives.
How We Got Here – Answers to the Questions I Have Been Asking
With these answers, perhaps we can begin talk about what kind of policies would FIX this mess, pretending we could get anyone to listen.
Can Someone Explain the Math on the Patient Copay for CTPs (Skin Substitutes)?
Where I come from, we’d say that something about this seems as crooked as a dog’s hind leg. However, it’s possible that I just don’t understand it, so I hope you will explain it to me.
The Other Side of the CTP/Skin Substitute Story – How Poorly-Crafted CMS Policies for Package Pricing in HOPDs Created This Mess
HOPDs lose money on CTP/Skin Substitute applications, while doctor’s offices make huge profits from the product. Why is this OK?
“We Will All Lose in the End.” Let’s Discuss the Moral Hazard of the CTP (Skin Substitute) Industry
If you want to send me a message to post anonymously, email me and I will review it and perhaps discuss it with you further.
If You Wonder Why CMS is Looking at Skin Subs, Check Out These Claims…
Can anyone tell me why no invoice is needed to submit these claims and exactly how these profits are being realized?
