Lance's Corner

AHRQ Issues Regulatory Update

Apr 29, 2025

The Agency for Healthcare Research and Quality (AHRQ) has issued its weekly regulatory update, which can be read below.

April 29, 2025, Issue #955

AHRQ Stats: Total Adult Outpatient Opioid Prescription Fills

There were 68.6 million outpatient prescription opioid fills between 2021 and 2022. Hydrocodone (25.2 million fills), oxycodone (19.2 million fills) and tramadol (14.1 million fills) accounted for most prescriptions. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #559, Average Annual Total Expenses, Total Utilization, and Sources of Payment for Outpatient Prescription Opioids in the U.S. Adult Civilian Noninstitutionalized Population, 2021–2022.)

 

Today's Headlines:

 

AHRQ Releases Toolkit To Prevent MRSA and Hospital Surgical Site Infections

AHRQ’s new toolkit can help tackle methicillin-resistant Staphylococcus aureus (MRSA) where surgical site infections (SSI) are most common, including cardiac, hip and knee replacement and spinal fusion surgeries. The AHRQ Toolkit for MRSA Prevention: Targeting SSI highlights four key evidence-based strategies to prevent MRSA and SSI: nasal decolonization, preoperative skin antisepsis, antimicrobial prophylaxis and evidence-based prevention strategies. Surgical teams can incorporate concepts from the AHRQ Comprehensive Unit-based Safety Program framework into their current care team to promote patient safety culture and enhance teamwork and communication. Access the toolkit’s extensive resources, including presentations and facilitator guides, plus staff and patient training materials to help your facility get started or supplement your existing MRSA and SSI prevention efforts.

 

Study Finds That Diagnostic Uncertainty Is Common in Pediatric Critical Care

Diagnostic uncertainty was relatively common in critically ill children admitted to the pediatric intensive care unit (PICU), an AHRQ-funded study in Critical Care Medicine concluded. Diagnostic uncertainty is the subjective perception of clinicians of their inability to provide an accurate explanation of a patient’s health problem. Researchers aimed to identify the frequency and factors associated with diagnostic uncertainty among critically ill children admitted to PICU. They reviewed the medical records of 882 patients admitted to one of four PICUs. Diagnostic uncertainty at admission was observed in 228 out of 882 patients. They also found a significant association between diagnostic uncertainty and diagnostic error. Researchers highlighted the need for more research and better strategies to address diagnostic uncertainty. Access the abstract.

 

New Research and Evidence From AHRQ

 

Webinar Recording Available for Units Interested in Free CLABSI Prevention Program

The AHRQ Safety Program for Healthcare-Associated Infection Prevention is now recruiting adult intensive care units (ICUs) and non-ICU hospital units for its central line-associated bloodstream infection (CLABSI) prevention cohort. In a webinar on April 21, Lisa Maragakis, M.D., M.P.H., co-investigator from Johns Hopkins University, presented the details of the program, which aims to prevent CLABSI while strengthening patient safety culture. She answered several questions about eligibility and the application process and noted that participation in the Safety Program could be beneficial even for hospital units that already have a CLABSI prevention program in place. Visit the website to access the recorded webinar or register for upcoming webinars on May 8 and 14. Apply for the program by June 30.

 

CAHPS Health Plan Survey Database Drives Quality Improvement

AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey Database offers national patient experience data from Medicaid, Medicare and private health plans that voluntarily submit results. Participating organizations receive customized feedback reports and access to national benchmarks, helping them measure and improve their quality of care. The database includes composite scores on key areas such as access to care and customer service, along with individual question-level data. Healthcare organizations, researchers and policymakers can use these insights to track trends, identify gaps and prioritize patient-centered improvements. Access the CAHPS Health Plan Survey Database.

 

Register for Upcoming Webinars

  • May 7, 1–2:30 p.m. ET: AHRQ Public Listening Session on Opportunities to Update the Patient Safety Indicators. AHRQ is conducting a gap analysis to identify opportunities to improve and expand Patient Safety Indicators, including into new care settings and populations. This webinar will share the interim findings of the analysis, featuring initial reactions from Sue Sheridan, M.I.M., M.B.A., and Peter Pronovost, M.D., Ph.D. Feedback is welcome from a broad range of stakeholders. 
  • May 8, 11–11:30 a.m. ET, and May 14, 2–2:30 p.m. ET: AHRQ Safety Program for HAI Prevention: CLABSI Recruitment Webinars. Learn how participants in the program will receive expert support to prevent infections and promote safety culture.
  • May 13, noon–1 p.m. ET: Implementing CMS’ Patient Safety Structural Measure (PSSM). This webinar from the National Action Alliance for Patient and Workforce Safety will include leaders on the front line of PSSM implementation and delve into tools and resources that support implementation of the five domains of the PSSM: Leadership Commitment, Strategic Planning and Organizational Policy, Culture of Safety and Learning Health System, Accountability and Transparency, and Patient and Family Engagement.

AHRQ in the Professional Literature

Care fragmentation, care continuity, and care coordination-how they differ and why it matters. Kern LM, Bynum JPW, Pincus HA. JAMA Intern Med. 2024 Mar; 184(3):236-7. Access the abstract on PubMed®.

Demographic, clinical, psychosocial, and behavioral predictors of continuous glucose monitor use in adults with type 2 diabetes. Morrow EL, Spieker AJ, Greevy RA, et al. J Gen Intern Med. 2024 Oct 25. [Epub ahead of print.] Access the abstract on PubMed®.

Medical care for patients with mental health and/or substance-use disorders: a qualitative investigation of emergency department patient experiences and recommendations. Isbell LM, Le V, Huff NR, et al. Health Serv Res. 2025 Mar 26:e14617. [Epub ahead of print.] Access the abstract on PubMed®.

Comparative effectiveness of on-pump versus off-pump coronary surgical revascularization related to postoperative acute kidney injury. Koshy SKG, Tharakan AK, George LK, et al. Am J Cardiol. 2025 Mar 1;238:9-11. Epub 2024 Nov 23. Access the abstract on PubMed®.

Patient and care team perspectives on an app to support Hospital at Home admission decision making. Kramer J, Kowalkowski M, Reeves K, et al. J Hosp Med. 2025 Jan;20(1):42-50. Epub 2024 Jul 29. Access the abstract on PubMed®.

Rural maternal health interventions: a scoping review and implications for best practices. Gordon RD, Kishi A, Brown JA, et al. J Rural Health. 2025 Jan; 41(1):e70007. Access the abstract on PubMed®.

Interhospital variability in cardiac rehabilitation use after cardiac surgery among Medicare beneficiaries. Fliegner MA, Hou H, Bauer TM, et al. J Thorac Cardiovasc Surg. 2025 Mar;169(3):916-23.e5. Epub 2024 Apr 20. Access the abstract on PubMed®.

Emergency department vestibular rehabilitation therapy for dizziness and vertigo: a nonrandomized clinical trial. Kim HS, Schauer JM, Kan AK, et al. JAMA Netw Open. 2025 Feb 3;8(2):e2459567. Access the abstract on PubMed®.

Contact Information
For comments or questions about AHRQ News Now, contact Karen Fleming-Michael, (301) 427-1798 or Karen.FlemingMichael@ahrq.hhs.gov.

 

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc