• Access Crisis Feedback Form

    Have recent policy or reimbursement changes affecting cellular, acellular, and matrix-like products (CAMPs), also referred to as skin substitutes, created barriers to patient access, or limited your ability to provide care using these clinically proven therapies? We invite you to share your experience. Your input is essential to informing evidence-based advocacy efforts aimed at protecting patient access.
  • Number of Active Patients Per Week (select one)
  • If you have seen an increase in complications due to lack of CAMPs access, please select all that apply:
  • Have policy changes, such as the initiation of the pre-approval through the WISeR program, and/or CMS’ fixed fee reimbursement schedule for CAMPs resulted in any of the following impacts on your practice or patients (select all that apply):
  • Select All States You Practice
  • Please select your MAC (all that apply)
  • Practice Type/ Setting (Check all that apply)

  • Consent and Use of Information
    By entering and submitting information through this form, you acknowledge and consent that the Wound and Hyperbaric Association (WHA) may use the information you provide for internal evaluation, research, advocacy planning, and program improvement related to patient access to cellular, acellular, and matrix-like products (CAMPs).

    You further acknowledge and agree that WHA, or a public relations firm acting on WHA’s behalf, may contact you to verify or clarify the information submitted. Verified information may be used to support advocacy activities intended to address current CMS policies that may adversely affect Medicare beneficiary access to CAMPs.

    WHA will not disclose, sell, or distribute your information to third parties for commercial marketing or other commercial purposes. Information may be shared with agents or contractors working on WHA’s behalf solely for validation, analysis, communications, or advocacy support consistent with these purposes.

     

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