Lance's Corner

AHRQ Issues Regulatory Update

Jul 1, 2025

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

AHRQ News Now title banner with AHRQ.gov URL

July 1, 2025 | Issue #964

In This Week's Issue: Youth mental health Grand Rounds; enhancing care coordination; sepsis data visualization; hospital-integrated cardiac care

Research Findings and Evidence Gaps in Youth Mental Health

Research has helped to establish effective diagnosis and treatment practices for child and adolescent mental health disorders, but gaps remain in patient-centered studies that explore “what is the best treatment for whom” and address limited access to care.  In a Grand Rounds webinar presentation hosted by AHRQ’s Evidence-based Practice Center (EPC) Program on May 22, the researchers behind three recent systematic reviews discussed their findings on the topic of child and adolescent mental health, and additional discussants offered insights.
  • “There are few head-to-head comparisons of treatments that are of major interest,” said Bradley Peterson, M.D., copresenter of the report ADHD Diagnosis and Treatment in Children and Adolescents.  “We need studies for parents and kids looking for the right treatment for them.”  The review found several promising diagnostic tools for attention deficit hyperactivity disorder, but the strength of evidence was generally low.  Both medications and psychosocial interventions improved core symptoms, but evidence was lacking on which interventions work best for which children.
  • In the review Diagnosis and Management of Obsessive Compulsive Disorders in Children, researchers identified the Child Behavior Checklist–Obsessive Compulsive Scale as an effective diagnostic tool, but its cost may pose access barriers in some primary care settings.  The review supported exposure and response prevention (ERP) as the first-line treatment for pediatric obsessive compulsive disorder.  Telehealth delivery of ERP also proved effective, offering promise for broader access.
  • The report Management of Suicidal Thoughts and Behaviors in Youth found dialectical behavior therapy to be the only treatment for suicidal ideation with sufficient strength of evidence.  Still, the studies in the review were limited by several factors.  “For future research, there is a need for large, well-designed randomized controlled trials with long followup periods,” said presenter Leslie Sim, Ph.D.
Access the meeting materials and information about previous Grand Rounds meetings, and stay up to date on the latest findings from AHRQ’s EPC Program.

Care Coordination Investments Improve Handoff Communications, Discharge Process

The updated Patient Safety Research Summary “Improving Patient Safety by Enhancing Care Coordination” summarizes AHRQ’s investments in care coordination—the process of organizing patient care activities and sharing information among all individuals concerned with a patient’s care to achieve safe and effective care.  Released in May, the summary provides examples of project findings and products, collective outputs, and impacts of this work.  Focus areas include improving handoff communication among providers, improving the discharge process, and exploring quality improvement strategies in a variety of healthcare settings.  The summary is the result of one of 47 patient safety research projects AHRQ supported from 2000 through 2024.  Collectively, the projects have resulted in the creation of a broad collection of tools and toolkits that help healthcare professionals implement evidence-based care coordination protocols into clinical care, among other impacts.  Review the Research Summary.

Interactive Sepsis Data Tool Updated With 2022 Data

AHRQ’s interactive sepsis data tool now includes data from 2022 and a map that shows statewide variation in hospital encounters involving sepsis.  The visualization, developed with statistics from AHRQ's Healthcare Cost and Utilization Project, allows users to explore trends in sepsis-related hospitalizations and emergency department visits starting in 2016.  Visualize the latest available data on patient outcomes by characteristics such as age and geographic location.  Check out the tool.

Patients of Hospital-Integrated Physicians More Likely To Receive Cardiac Rehabilitation

According to an AHRQ-funded study in JAMA Network Open, patients who receive care from physicians who are employed by hospitals (hospital-integrated physicians) after a cardiac event are 11 percent more likely to participate in cardiac rehabilitation than those who see an independent physician.  Researchers reviewed the Medicare Part A and B claims of 28,596 patients hospitalized for a cardiac event that made them eligible for cardiac rehabilitation between 2016 and 2019.  They found that 9,037 patients—31.6 percent overall—received care from a hospital-integrated physician.  Of these patients, 33 percent received cardiac rehabilitation, a medically supervised program for improving heart health.  Additionally, cardiac rehabilitation was associated with a 14 percent decrease in the odds of future cardiovascular-related hospitalizations.

AHRQ Stats: Average Expenditures for Major Diet-Related Conditions

In 2021 and 2022, the average annual cost to treat breast or colorectal cancers was $9,202 per treated person—the most among three groups of diet-related conditions.  Treatment for diabetes cost an average of $5,925 per treated person, and treatment cost for cardiovascular diseases averaged $2,176.  (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #561, Expenditures for Key Diet-Related Health Conditions, 2021–2022.)

AHRQ in the Professional Literature

A telehealth approach to central line-associated bloodstream infection prevention activities in nursing homes: the SAFER lines program.  Singh RD, Bahadori B, Tjoa T, et al. Infect Control Hosp Epidemiol. 2025 Mar;46(3):236-42. Epub 2025 Feb 3.  Access the abstract on PubMed®.

Automating the addiction behaviors checklist for problematic opioid use identification.  Chatham AH, Bradley ED, Troiani V, et al. JAMA Psychiatry. 2025 Jun;82(6):591-8.  Access the abstract on PubMed®.

An evaluation framework for ambient digital scribing tools in clinical applications.  Wang H, Yang R, Alwakeel M, et al. NPJ Digit Med. 2025 Jun 13;8(1):358.  Access the abstract on PubMed®.

Effectiveness of a clinical decision support system with prediction modeling to identify patients with health-related social needs in the emergency department: study protocol.  Mazurenko O, Harle CA, Blackburn J, et al. PLoS One. 2025 May 12;20(5):e0323094.  Access the abstract on PubMed®.

Clusters of health-related social needs among adult primary care patients.  Vest JR, Wu W, Conner K. J Am Board Fam Med. 2025 May 12;38(1):119-24.  Access the abstract on PubMed®.

Development and validation of computable social phenotypes for health-related social needs.  Gregory ME, Kasthurirathne SN, Magoc T, et al. JAMIA Open. 2025 Feb;8(1):ooae150. Epub 2025 Jan 7.  Access the abstract on PubMed®.

Drivers of infliximab biosimilar uptake: a comparative analysis of new biosimilar initiations versus switching in a national rheumatology registry.  Roberts ET, Bansback N, Tseng CW, et al. Health Serv Res. 2025 Jun;60(3):e14410. Epub 2024 Dec 1.  Access the abstract on PubMed®.

A scoping review of trauma-informed language in the care of injured patients.  Hart LD, Kallepali P, Castater CA, et al. J Surg Res. 2025 Apr;308:264-9. Epub 2025 Mar 22.  Access the abstract on PubMed®.

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