by Caroline Fife, M.D. | Aug 30, 2016 | Fight the Good Fight, Health Information Technology and Wound Care, Hyperbaric Oxygen Therapy
The Hyperbaric oxygen therapy prior authorization project has been in effect a little more than a year and CMS is in the process of reviewing its impact to prepare an interim report. As the Medicare coffers dwindle, we have to ask ourselves how we can best utilize...
by Caroline Fife, M.D. | Aug 3, 2016 | Fight the Good Fight, Health Information Technology and Wound Care
Your Complimentary Copy of the UHMS Pressure Newsletter – Summer Issue...
by Caroline Fife, M.D. | Jul 29, 2016 | Fight the Good Fight, Health Information Technology and Wound Care
Friday’s Featured Friend and Guest Blogger is none other than Helen Gelly, MD, FUHM, FACCWS, UHM/ABPM. When it rains, it pours. There seems to be no end to the rain clouds on the horizon for hyperbaric medicine. But HBO is not the only specialty at risk. CMS...
by Caroline Fife, M.D. | May 9, 2016 | Fight the Good Fight, Health Information Technology and Wound Care
As shared by Renee Duncan of UHMS, “Pressure” the official newsletter of UHMS Membership is now open access (now listed under ‘Publications’ on the home page). This means you can invite your colleagues who may be considering membership in the...
by Caroline Fife, M.D. | May 5, 2016 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program
I’m picking up where I’d left off before SAWC Spring – explaining MIPS, the Merit-Based Incentive Payment System. Although MIPS does not begin until 2017, 85% of the MIPS score is derived from performance in the 2 quality programs that clinicians...
by Caroline Fife, M.D. | Nov 23, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
As the post-payment review process for HBOT rolls out across the USA, hyperbaric clinicians are going to need to do a lot of thinking about the role of hyperbaric oxygen therapy, their approach to patient care, and their relationship to the medical record. CMS is...
by Caroline Fife, M.D. | Nov 16, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Last week I took a walk down memory lane to tell you about the way the field of hyperbaric medicine nearly ended in 1999. We got a reprieve during which we could have changed the course we were on, but we didn’t. Currently, Medicare has initiated a pilot program...
by Caroline Fife, M.D. | Sep 22, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Yesterday I posted some of the reasons for denial of HBOT under prior authorization. I thought I’d point out something that should be obvious but might not be. It appears that HBOT is being denied for DFUs unless—at a bare minimum: Hemoglobin A1C is being checked and...
by Caroline Fife, M.D. | Sep 21, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
The Centers for Medicare & Medicaid Services (CMS) has implemented a prior authorization model for non-emergent hyperbaric oxygen therapy in Illinois, Michigan, and New Jersey. It is the position of CMS that it can reduce spending on HBOT services while...
by Caroline Fife, M.D. | Sep 1, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Here’s some straight talk on clinical pathways. We’ve all gotten the message on “evidence based” medicine by which payers use data, primarily from randomized controlled trials (RCTs) to decide what treatments they will cover. I’ve had some concerns about that since...
