Bandages made of medical waste cost Medicare $10B last year—limits are coming

Trump administration has delayed a Biden-era fix twice, but is now set to cap price.

See full article...

 

[myk.dinis]

Yeah, double the amount being paid to United, the biggest medical fraudster out there, and reduce this one small item, that'll definitely reduce waste.

<sigh>

 

[no_free_lunches_for_ai]

As someone who is in the process of going through the complaint process because I was given an ankle brace when I went in for a sprain and was subsequently billed $600 ($400 after "savings") for the said ankle brace (found online for $30). Let me just say very clearly.

Fuck every single person involved with these systems with a red-hot poker and may they never get another good nights sleep.

 

[poochyena]

Reminder that the US spends more on healthcare than any other country in the world, and doesn't even have the best coverage

 

[drinkingcoffee]

That whole NYT article is wild:

Another high earner, Dr. Stephen Dubin of Las Vegas, was paid $17 million by Medicare for skin substitutes in 2024. (He estimated that after expenses, he took home roughly $4 million.)

Dr. Dubin told The Times that he purchased bandages from Legacy with a large discount. “They float out a percentage, it’s usually 60/40 — they’re getting 60, you’re getting 40,” he said, referring to the portion of the Medicare reimbursement.

Dr. Dubin said he placed bandages only on wounds that hadn’t healed with the standard of care. But he said that many unqualified doctors were using bandages inappropriately to reap the easy money.

“It’s lucrative, and it’s low risk,” he said. “You’re not going to get sued for putting a membrane on somebody.”

Dr. Dubin retired at the end of last year, in part, he said, because of increased competition for wound patients. Sometimes he would show up at a patient’s home only to find that someone from a different clinic had placed a new skin substitute the day before.

Are these bandages used in other countries?

 

[-Locke-]

a spokesperson for a bandage industry trade group said: “If this exceedingly low payment rate were to take effect, companies producing skin substitutes would no longer be able to cover their production costs, and providers would not be able to afford to treat their patients."

Oh no! Anyway

 

[luckydob]

Reminder that the US spends more on healthcare than any other country in the world, and doesn't even have the best coverage
View attachment 113905

Get rid of PBM's. That will be a start and it will save everyone (except CVS Caremark, Express Scripts and Optum Rx) a ton of $$.

 

[jandrese]

This is yet another example of how so much of the waste in medical billing is insurers and providers constantly trying to game the system looking for some loophole they can exploit. The big insurers are the worst since they have the scale to instantly exploit anything they find hundreds or thousands of times over.

It's a shame that removing this would require socializing our healthcare and that's a nonstarter because the people who profit from these schemes are too deeply embedded in DC to ever let such a thing exist. Even with Obamacare the socialized medicine provisions were cut almost immediately because there was too much profit at risk.

Maybe if we started actually punishing companies, and especially the CEOs of those companies, that engage in such shameless behavior? But that's would involve punishing rich people and that's always politically fraught. You need constant pressure from the public to even stand a chance and good luck now that all of the major media outlets are billionaire owned.

Meanwhile, Mehmet Oz, current administrator of the Centers for Medicare & Medicaid Services, said the administration is "cracking down on abuse that drives up costs."

This would be more reassuring coming from anybody but Doctor Oz, who has been grift adjacent for his entire career.

 

[deltaproximus]

Bandages from infant foreskin? I hope they give the baby a cut.

 

[GenocideOwl]

Finding actual fraud and abuse?

Stopped clocks and all I guess.

 

[ItchyPoo]

WTF… foreskin and placentas bandages? 10 BILLION DOLLARS!?! Can a republican please explain to me, in simple terms that an educated liberal can comprehend, how these current sleazebags you voted for are saving money for the federal governmenty?

 

[jandrese]

Reminder that the US spends more on healthcare than any other country in the world, and doesn't even have the best coverage
View attachment 113905

What's going on in Venezuela where they're providing 85% of the coverage for 1% of the cost?

 

[deltaproximus]

What's going on in Venezuela where they're providing 85% of the coverage for 1% of the cost?

I think they call it socialism.

 

[Hacker Uno]

Isn't gold anti-microbial? (I know copper and silver are.) For their reimbursement allowance, they could cover the wound with solid gold leaf!

 

[jandrese]

I think they call it socialism.

Lots of socialist countries on that list are performing at nowhere near that level of efficiency.

 

[deltaproximus]

Lots of socialist countries on that list are performing at nowhere near that level of efficiency.

Like with most medicines, benefits of socialism may vary. Consult an expert if you experience side effects such CIA infiltration or military coup attempts.

 

[mknelson]

WTF… foreskin and placentas bandages? 10 BILLION DOLLARS!?! Can a republican please explain to me, in simple terms that an educated liberal can comprehend, how these current sleazebags you voted for are saving money for the federal governmenty?

$21,000 per square inch? Somebody owes me $42,000!

Beth finds the weirdest stories!

 

[ubercurmudgeon]

The Times noted that Trump had received a large campaign donation from a leading bandage maker.

These guys should know that you've got to keep writing new checks, especially if you're engaged in a business so egregious that Trump will consider revisiting Biden-era legislation to deal with the problem.

 

[fisherjeff]

If you ever find yourself re-releasing the same product under a new name every six months for no other purpose than to take advantage of a loophole that makes you rich, it may be time to reevaluate your life. Especially if that loophole comes at the expense of others’ healthcare.

 

[hob_g]

Reminder that the US spends more on healthcare than any other country in the world, and doesn't even have the best coverage
View attachment 113905

Um note the scaling on the $ axis. It makes the difference in spending between eg Italy and the US look small when it is well over twice as much in dollars

 

[Steve austin]

Is there a reason why these are covered at all? Have any gone through propel testing for safety and efficacy, especially the latter? Medicare (as far as I know) rejects reimbursement for things that are not both judged efficacious (by the FDA, I’d think) and medically necessary - and while there are cases that slip through, they are considered fraud, not just overpriced treatments.

 

[DarthSlack]

Uh, did you read the article? It's being addressed and the 10 BILLION DOLLARS was from 2024, before the latest sleazebags were voted in on both sides (actually took office...voting was in November of 2024).

I would hope an educated liberal/conservative can RTFA.

Edit: clarification on taking office vs. being voted into office

I would point out that the latest sleazebags had an entire department devoted to finding exactly this kind of waste. Headed by the worlds richest man no less. And they entirely missed it. In fact they did the opposite, they screwed up everything so badly that the plan to stop the waste was stopped instead of the waste.

 

[AdamM]

This is yet another example of how so much of the waste in medical billing is insurers and providers constantly trying to game the system looking for some loophole they can exploit. The big insurers are the worst since they have the scale to instantly exploit anything they find hundreds or thousands of times over.

It's a shame that removing this would require socializing our healthcare and that's a nonstarter because the people who profit from these schemes are too deeply embedded in DC to ever let such a thing exist. Even with Obamacare the socialized medicine provisions were cut almost immediately because there was too much profit at risk.

Maybe if we started actually punishing companies, and especially the CEOs of those companies, that engage in such shameless behavior? But that's would involve punishing rich people and that's always politically fraught. You need constant pressure from the public to even stand a chance and good luck now that all of the major media outlets are billionaire owned.


This would be more reassuring coming from anybody but Doctor Oz, who has been grift adjacent for his entire career.

I get your point overall, but given this article is about Medicare paying $10 billion for shit that doesn't work and isn’t typically covered by private insurance companies. This probably isn't the evidence I’d use to make the case.

 

[OldPhartReef]

Like so many things, the healthcare & insurance industries are good examples of unintended consequences. Unfortunately, policy and decision making is a political process rather than a rational one.

 

[megabaseballdork]

I hate these political posts more than anything, but, for my information, did the price suddenly jump in 2024, or was there a steady increase from 2019. Either way, this seems a product of the previous administration that is finally being fixed. I am really not picking a fight, just tired of the political posts.

Why don't you read the article?

 

[poochyena]

Um note the scaling on the $ axis. It makes the difference in spending between eg Italy and the US look small when it is well over twice as much in dollars

Good point. I just realized I can edit it too

https://ourworldindata.org/grapher/haq-by-level-of-healthcare-spending-endpoints?xScale=linear

 

[A Man A Plan A Canal Panama]

Interesting topic.

Several years ago I tried a half dozen different such skin products for grafts

(hole on foot where abscess was removed, wasn't closing - pix available, just ask!)

None of the products did anything! Most just dissolved, disappeared after a day or so.

I and my podiatrist and dermatologist concluded that none of the products did anything; we hoped but this matched other patients' experience.

Prices ranged from $100/sq inch to $8500/sq inch.

 

[megabaseballdork]

You know, I tried to follow the references in Trump's tweet here:
https://truthsocial.com/@realDonaldTrump/posts/114093529028938304

It takes me here:
https://www.magonlinelibrary.com/toc/jowc/31/10

Which is a list of articles, I'm guessing the last one is the one being referenced? It's pay access only, even sci-hub doesn't have it. This drives me nuts. I have a hard time believing the Trump post is faithfully representing what is said in the article, but I have no way of verifying without dropping $30. I really wish this stuff was publicly funded and forced to be published openly.

 

[SixDegrees]

Why don't you read the article?

Reading is hard.

 

[Erbium68]

Bandages from infant foreskin? I hope they give the baby a cut.

I wonder how much goes to the mohel and how much to the rabbi?

 

[Anton Longshot]

Hmmm could one create a new human out of a pile of these bandages?
This needs to be researched ASAP.
Should this work the stuff might actually be worth the price, especially as the new creatures could be used to replace born workers.
Experience taught me there are probably one or two commenters that need me to explain this is a joke but I don't have time and must leave now. Sorry!

 

[ColdWetDog]

WTF… foreskin and placentas bandages? 10 BILLION DOLLARS!?! Can a republican please explain to me, in simple terms that an educated liberal can comprehend, how these current sleazebags you voted for are saving money for the federal governmenty?

Well, you're asking the wrong question. That's likely because you're a communist. And your mother wears Army boots. And it is clearly pointed out in TFA - IT'S BIDEN'S FAULT. He didn't do enough to stop it on time so we had to help out the capitalist innovators so we could get more jobs. And 10 billion dollars is nothing compared to Hilary's emails.

It's going to be BEAUTIFUL!!!!!

There. Did that help?

(The above satirical post not associated MAGA, Nazis, the KKK, or the John Birch Society. As far as we know. But it could be, but then that would be Obama's fault anyway.)

 

[odikweos]

Good reporting. The no surprises act should probably be amended to cover this too since it's another form of what that law was trying to deal with.

 

[ItchyPoo]

Uh, did you read the article? It's being addressed and the 10 BILLION DOLLARS was from 2024, before the latest sleazebags were voted in on both sides (actually took office...voting was in November of 2024).

I would hope an educated liberal/conservative can RTFA.

Edit: clarification on taking office vs. being voted into office

my take was Biden tried to reduce the payments and Trump kept stopping that. Plus Trump put in an entire, overly hyped, fraud and waste stopping team. My point was they could have jumped all over this. Definitely agree Medicare should not be paying for this under any party.

 

[ColdWetDog]

Interesting topic.

Several years ago I tried a half dozen different such skin products for grafts

(hole on foot where abscess was removed, wasn't closing - pix available, just ask!)

None of the products did anything! Most just dissolved, disappeared after a day or so.

I and my podiatrist and dermatologist concluded that none of the products did anything; we hoped but this matched other patients' experience.

Prices ranged from $100/sq inch to $8500/sq inch.

This grift exists because non healing lower extremity skin ulcers are a real medical problem. Despite quite a bit of real research, very little progress has been made. We're basically treatments which sound suspiciously like remedies described in Egyptian texts (really).

Given the absolutely chronic dysfunction of the FDA (due in part to defunding and other Congressional meddling) and the lax rules surrounding Medicare reimbursement it's just much easier to fake it. After trying the usual and customary treatments for weeks to months, people are primed to go for anything.

 

[Fatesrider]

In a statement to the Times this week, a spokesperson for a bandage industry trade group said: “If this exceedingly low payment rate were to take effect, companies producing skin substitutes would no longer be able to cover their production costs, and providers would not be able to afford to treat their patients."

And nothing of value will be lost.

Investor profits I have no shits to give about anymore (and really haven't since about 1989 when corporations started first becoming more about profits and growth than quality and reputation).

Way back in the day, like nearly 50 years ago when I was doing active patient care on people with these kinds of issues/injuries/conditions, there were perfectly good ways to deal with these wounds that were simple, cheap and as effective as what they have now (which isn't hugely, but better than nothing).

If this makes a bean-counter cry, I'm good with it.

 

[JudgeMental]

THIS is the kind of fraud that exists and should be investigated. But because it's largely private capital (ie, not the poors) draining the coffers of publics funds, it's not what the right wing is interested in.

I'm a bit surprised something is being done about it since it sounds exactly like the kind of thing one of RFK Jr's friends would be into.

 

[Niles Gazic]

Isn't gold anti-microbial? (I know copper and silver are.) For their reimbursement allowance, they could cover the wound with solid gold leaf!

Gold and platinum are the two most chemically unreactive metals, so I found this discovery interesting...

"Noble metal nanoparticles like silver nanoparticles (AgNPs) and gold nanoparticles (AuNPs) exhibit unique properties, which are different from their bulk counterparts and hence have diverse applications including as antimicrobial entities. Bimetallic (Ag-Au) could exert better effects in a synergistic manner."

https://www.sciencedirect.com/science/article/abs/pii/B9780323994545000135