🇺🇸United States
Regulatory policy changes eliminate revenue offset mechanisms
0
Definition
New CTP (cellular and tissue-based products) policies restrict skin substitute billing, which previously offset losses from low reimbursement rates. Compliant providers who used skin substitutes conservatively are now squeezed by policies that remove this revenue source, while fraud elsewhere in the industry triggered the crackdown.
Key Findings
- Financial Impact: Described as 'eliminate a major portion of a provider's revenue overnight'
Why This Matters
This pain point represents a significant opportunity for B2B solutions targeting Mobile Wound Care Services in USA.
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Financial Impact
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Current Workarounds
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Methodology & Sources
Data collected via OSINT from regulatory filings, industry audits, and verified case studies.
Related Business Risks
Explosive growth in skin substitute spending with fraud
$10+ billion Medicare Part B spending on skin substitutes (industry-wide)
Unverified efficacy and patient harm from inappropriate treatment
Not quantified but includes litigation risk, regulatory fines, and patient harm liability
Excessive Skin Substitute Billing
$10B+
Skin Substitute Fraud Waste Abuse
$10B+ annually for Medicare
Medicare fraud liability from upcoding schemes
Variable - settlements range $45M-$309M
Explosive Medicare Part B spending scrutiny
Estimated $10,000,000,000+ market at risk
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