Lance's Corner

AHRQ Issues Regulatory Update

Jun 17, 2025

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

June 17, 2025, Issue #962

AHRQ Stats: Federal Insurance Spending for Diet-Related Care

Among all federal health insurance providers, Medicare was the highest spender for major diet-related conditions during 2021 and 2022, with an average of $153 billion per year in expenditures. The Department of Veterans Affairs, TRICARE and other federal programs spent an average of $13 billion annually. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #561, Expenditures for Key Diet-Related Health Conditions, 2021-2022.)

Today's Headlines:

Hospital Unit Lowers C. diff Infections Using AHRQ Safety Program

Using AHRQ’s Comprehensive Unit-based Safety Program (CUSP), Henry Ford Hospital in Detroit has reduced the incidence of Clostridioides difficile (C. diff) infections in its nephrology unit by 90 percent since January 2023. The hospital used the CUSP framework to engage frontline staff and significantly reduce hospital-acquired C. diff, a dangerous and highly contagious infection. Some of these interventions have now been adopted across the 800-bed hospital. The hospital nephrology unit's C. diff team is pictured above.

CUSP is a method that can help clinical teams make care safer by combining improved teamwork, clinical best practices and the science of patient safety. The Core CUSP toolkit gives clinical teams the training resources and tools to apply the CUSP method and build their capacity to address patient safety issues.
Patients in the 34-bed nephrology unit are vulnerable and at high risk of infection; many need dialysis multiple times each week. Those with end-stage renal disease are twice as likely to develop C. diff as other patients. Using a nurse-driven protocol to verify C. diff in patients with symptoms, the nephrology unit launched a number of interventions in early 2023 to bring down the number of C. diff infections.

Within the first year, the hospital-onset C. diff rate dropped by about 70 percent; by the end of 2024, it was down 90 percent. Learn more in a new AHRQ impact story. All AHRQ impact stories are available for viewing here.

One in Seven Patients With Pancreatic Cancer Seeks Second Opinion

An AHRQ-funded study in Journal of the American College of Surgeons found that one in seven patients diagnosed with pancreatic ductal adenocarcinoma sought a second surgical opinion. Researchers analyzed 116,072 records of Medicare beneficiaries diagnosed with this pancreatic disease between 2013 and 2020 and found that patients who sought a second opinion were six times as likely to have surgery as those who consulted with only one surgeon. However, outcomes were generally similar for both groups. According to the authors, these findings indicate a need for further research to better understand how factors like personal motivations, referrals, disease characteristics and treatment options work alongside the number of surgical opinions to influence patients’ decisions regarding surgery for pancreatic ductal adenocarcinoma, a condition diagnosed in 64,050 Americans in 2023. Access the abstract.

July 8 Webcast: Use Hospital Survey for CMS Safety Requirement

On July 8, from noon to 12:45 p.m. ET, join the webcast "Understanding the Centers for Medicare & Medicaid Services (CMS) Patient Safety Structural Measure Requirements for Hospitals." This 45-minute webcast will provide an overview of CMS's Patient Safety Structural Measure and use of the AHRQ Surveys on Patient Safety Culture® (SOPS®) Hospital Survey, and a shorter HSOPS pulse survey version, to meet requirements for Domain 3: Culture of Safety & Learning Health Systems. The presentation will include the following speakers:

  • Kristina Rabarison, Dr.P.H., M.S., Social Science Analyst, CMS
  • Jonathan Bakdash, Ph.D., Social Science Analyst, AHRQ
  • Naomi Yount, Ph.D., Principal Research Associate, Westat
  • Joann Sorra, Ph.D. (Moderator), Vice President, Westat

Register now or visit the website to learn more about the SOPS Hospital Survey.

Last Informational Webinar for CLABSI Prevention Program: June 24

AHRQ is seeking intensive care units (ICUs) and non-ICUs to join a free nine-month program beginning in July to implement strategies to reduce central line-associated bloodstream infections (CLABSI). Participants will receive free expert consultation to promote infection prevention procedures, regular benchmarking reports, guidance on enhancing teamwork and continued education credits. Register now for the webinar, to be held June 24, noon-12:30 p.m. ET. Recruitment is open to all states, particularly those located in the Midwest, Alaska and the Northwest.

Register for Upcoming Webinars

AHRQ in the Professional Literature

Person-centered preventive health care: gathering stakeholder input on evidence and implementation. Kahwati LC, Aboumatar HJ, Banger AK, et al. AJPM Focus. 2025 Apr;4(2):100319. Epub 2025 Jan 31. Access the abstract on PubMed®.

Use of telemental health care by children and adolescents in the United States. Olfson M, McClellan C, Zuvekas SH, et al. Am J Psychiatry. 2025 May;182(5):493-6. Epub 2025 Jan 15. Access the abstract on PubMed®.

Surveillance-associated anxiety after curative-intent cancer surgery: a systematic review. Khatri R, Quinn PL, Wells-Di Gregorio S, et al. Ann Surg Oncol. 2025 Jan;32(1):47-62. Epub 2024 Sep 29. Access the abstract on PubMed®.

Communicating blood test results in primary care: a mixed-methods systematic review. Nankervis H, Huntley AL, Whiting P, et al. Br J Gen Pract. 2025 Apr;75(753):e222-e231. Epub 2024 Mar 27. Access the abstract on PubMed®.

Digital supervision in the clinical learning environment: characterizing teamwork in the electronic health record. Cross DA, Weiner J, Olson APJ. J Hosp Med. 2025 Apr;20(4):352-9. Epub 2024 Oct 13. Access the abstract on PubMed®.

Changes in primary care practice setting and practice type for Medicare beneficiaries. Bond AM, Schpero WL, Civelek Y, et al. JAMA Health Forum. 2025 Apr 4;6(4):e250445. Access the abstract on PubMed®.

Association of limited health literacy with frailty, health-related quality of life, and health care utilization among older adults with cancer: the Cancer and Aging Resilience Evaluation Registry. Padamatinti S, Fowler ME, Stephenson C, et al. JCO Oncol Pract. 2025 May;21(5):720-8. Epub 2024 Nov 8. Access the abstract on PubMed®.

Timing of off-label dosing of direct oral anticoagulants in three large health systems. Herron GC, DeCamillo D, Kong X, et al. Thromb Haemost. 2025 Mar;125(3):278-85. Epub 2024 Jul 15. Access the abstract on PubMed®.

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

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