CTP / Skin Substitute Arrests
Slide Deck for the December 20, 2024 CGS Education Webinar on the Soon to Be Implemented “Skin Substitute” LCD
This skin substitute LCD webinar reviews the LCD requirements for the treatment of Diabetic Foot Ulcers (DFUs) and Venous Leg Ulcers (VLUs).
The US Cellular Tissue Product (CTP) / Skin Substitute Market Reached $1.75 Billion in the Third Quarter of 2023, Based on SmartTrak Analysis
Amniotic products held the vast majority of the US market at 79.1% share, up from 73.3% in Q323.
Compared to the Third Quarter, the Cellular Tissue Product (CTP) / Skin Substitute Market Grew 64% in the Fourth Quarter of 2024
Three market leaders combined represent 43.5% of the market share.
The Accountable Care Organizations are Watching…
If you are a big user of skin subs, particularly among patients who are participating in an ACO, the ACO knows you by name.
Get that Skin Substitute “Clawback Insurance!”
What worries me the most is that that the DOJ may get to decide whether a discount on a skin substitute was actually a kickback.
“I’ve Consistently Been Told the Answer is Yes… At Least, I Hope it’s Yes — Otherwise, We’re All in Trouble.”
When calculating the ASP for future quarters, the new ASP is supposed to account for any discounts offered. This process helps Medicare save money over time.
Why Aren’t Patients Up in Arms About Huge Copays for Cellular Tissue Products (CTPs) / Skin Substitutes?
Given the meteoric increase in the use of CTPs, I wonder how many patients and/or families have been hurt by staggering copays?
According to Medicare Data Analyzed by SmartTRAK, Recent DOJ Prosecutions in the Cellular Tissue Product / Skin Substitute Market are the “Tip of the Iceberg”
It seems unlikely that we will see new developments in the field of wound care until there is a very big housecleaning.
Two Nurse Practitioners Charged in Connection with APX Scheme with Fraudulent Application of Amniotic Products
District of Arizona | Seven Charged in Arizona as Part of the Department of Justice’s 2024 National Health Care Fraud Enforcement Action | United States Department of Justice The fallout continues...
Wound Care Company Owners Arrested, Accused of Accepting More Than $330M in Kickbacks Relating to Medicare Charges for Amniotic Products
The report states that more than $900 million in bogus claims were submitted to Medicare for amniotic products applied to fewer than 500 patients. Yes, that is $1.8 million PER PATIENT.
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