For Florida patients with chronic wounds, especially those with diabetes, vascular disease, or other complex conditions, healing isn’t simple. It often requires advanced therapies like cellular, acellular, and matrix-like products, also known as skin substitutes. These products are more than clinical innovations, and for many of my patients, they have meant the difference between amputation and recovery.
Concern is mounting not just in the plastic surgery community but with medical providers broadly around a proposed policy by the Centers for Medicare & Medicaid Services (CMS) that if implemented, would dramatically restrict patients’ access to these life-changing, life-saving products. This policy, advanced originally under the Biden Administration, would slash the number of available skin substitute products from more than 200 to just 15, a drastic 93% reduction in the options available to treat patients.
This isn’t a political debate. It’s a direct threat to my patients’ health. Every year, I treat many Floridians whose wounds will not heal without these therapies and without them, many will face infection, hospitalization, and limb loss.
With one of the largest and most diverse patient populations in the country, nearly 3 million Floridians live with diabetes, not to mention it has one of the nation’s largest aging populations. Diabetes-related wounds, pressure ulcers, and venous leg ulcers already lead to thousands of amputations annually, many of which could be prevented with timely, appropriate advanced wound care.
This policy doesn’t just limit patient options, for some patients it eliminates them. The nearly 3 million Americans who suffer from pressure wounds each year won’t have access to any skin substitute products. That’s not cost cutting, that’s the federal government turning its back on patients who need care the most.
No two patients – and no two wounds – are the same. What works for a patient here in South Florida may fail for someone in rural North Florida. Climate, circulation, nutrition, and underlying health conditions all affect healing. That’s why physicians rely on a diverse range of skin substitute products – each with their own unique properties and benefits – to tailor treatments and care for our patients. Our ability to deliver individualized, evidence-based care based on the properties of the individual wound is only possible with this access.
Reducing the list to just a handful of products ties our hands as clinicians and forces patients into a one-size-fits-all model that results in patient harm. Patients will simply have no effective options left to treat their non-healing wounds.
This proposed policy was introduced to allegedly reduce federal spending on skin substitute products. But in reality, restricting access to proven wound care therapies will do the opposite. Non-healing wounds are among the most expensive and resource intensive conditions to treat in the healthcare system.
When wounds don’t heal, patients require more visits to the doctor, more medications, longer hospital stays, and even more surgeries. And that adds stress to an already taxed healthcare system. Our patients benefit from access to cutting-edge therapies and clinical expertise that improve their outcomes and quality of life. And every wound that could have healed but doesn’t will cost Medicare – and Florida taxpayers – far more in the long run.
As a plastic surgeon, we’ve seen this trend before: when innovation and access is limited, costs go up and patient outcomes worsen. CMS’s proposal risks turning back the clock on decades of progress in wound care, plastic surgery research, and healthcare overall,
Patients benefit from access to cutting-edge therapies and clinical expertise that improve their outcomes and quality of life. Instead of encouraging the next generation of life-saving technology, CMS’s proposal says that progress does not matter.
Florida physicians and regulators share a goal: better outcomes at a lower cost. But CMS’s plan achieves neither. I urge the Trump Administration to reject this reckless policy and preserve patient access to the full range of clinically proven wound care therapies.
For the thousands of Floridians struggling to heal from chronic wounds, this isn’t about product lists or policy memos – it’s about a chance to walk, to work, and to live without pain.
Let’s make sure patients have that chance.
Dr. Daniel Kapp, M.D., is an accomplished, board-certified plastic surgeon who practices in south Florida.
