Tag: skin substitutes
MACs withdraw new coverage policies for skin substitutes
December 29, 2025HME News Staff
WASHINGTON – The A/B Medicare Administrative Contractors (MACs) are withdrawing the local coverage determinations (LCDs) for skin substitute grafts/cellular and tissue-based products for the treatment of diabetic foot ulcers and venous leg ulcers that were scheduled to go into effect Jan. 1, 2026.
The Centers for Medicare & Medicaid Services (CMS) made the announcement on Dec. 24, only days after announcing that the MACs would release updated LCDs that...
In brief: Study links OSA & mental health, MACs drop LCDs, CMS invests in rural health
December 29, 2025HME News Staff
YARMOUTH, Maine - Middle-aged and older adults at high risk of obstructive sleep apnea (OSA) had consistently worse mental health outcomes, according to a national longitudinal cohort study published in the Journal of the American Medical Association (JAMA). Key points from the study:
Question: Is high risk of OSA associated with increased odds of concurrent and future mental health conditions among middle-aged and older adults?
Findings: In this...
MACs to issue final LCDs for skin substitute products effective Jan. 1, 2026
December 17, 2025HME News Staff
WASHINGTON – The seven A/B Medicare Administrative Contractors (MACs) will release updated final Local Coverage Determinations (LCDs) for skin substitute grafts and cellular/tissue-based products used to treat diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) that will be effective Jan. 1, 2026, according to a Dec. 15 Fact Sheet from the Centers for Medicare & Medicaid Services (CMS).
Key highlights of the LCDs
Expanded access: Medicare...
Convatec responds to CMS’s revised payment rate for skin substitutes
November 4, 2025HME News Staff
LONDON – Convatec says CMS’s revised payment rate for skin substitutes represents an estimated headwind of about 1% to 2% of Group revenue for 2026. That is unchanged from the company’s guidance from the first half of 2025. CMS announced Oct. 31 that it plans to pay $127.28 per sq cm for skin substitutes starting Jan. 1, 2026. Convatec makes InnovaMatrix, a placental-derived, FDA-cleared medical device...
CMS final rule modernizes payment accuracy, cuts spending waste
November 3, 2025HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) says its calendar year (CY) 2026 Medicare Physician Fee Schedule (PFS) final rule reduces waste and unnecessary use of skin substitutes and introduces a new payment model focused on improving care for chronic disease management.
“CMS is working to strengthen and transform Medicare for the current and future generations while cracking down on waste and abuse that drives up costs,” said CMS Administrator Dr....
In brief: Quipt Home Medical buyout bid, ACO performance, skin substitute spend
September 10, 2025HME News Staff
WILDER, Ky. – The tug of war between Quipt Home Medical and Forager Capital Management continues. Quipt has reportedly filed a lawsuit against Forager, one of its largest shareholders, and Forager has released a statement standing by its offer to buy Quipt for $3.10 per share in cash.
Quipt in late August responded to Forager’s offer, saying it was only the latest in the firm’s “self-serving inferior and declining offers.” Quipt noted that Forager had previously...
CMS targets chronic disease management
July 15, 2025HME News Staff
WASHINGTON – CMS is proposing changing the Medicare Diabetes Prevention Program to allow more people to access coaching and peer support, as well as practical training in dietary change, physical activity and behavior change strategies, to delay or prevent the onset of Type 2 diabetes for those with prediabetes.
In a new proposed rule, the agency also seeks to remove 10 quality measures that it says did not improve health outcomes and add five new measures that focus on the prevention...
CMS delays final LCD for skin substitutes
April 14, 2025HME News Staff
WASHINGTON – As part of the transition to the new administration, CMS is reviewing its coverage policies for skin substitute products. This means the final local coverage determinations for skin substitute grafts/cellular and tissue-based products for the treatment of diabetic foot ulcers and venous leg ulcers will be delayed until Jan. 1, 2026. “CMS believes it is important to maintain patient access to skin substitute products with high quality evidence of effectiveness,” the...