Lance's Corner

AHRQ Issues Regulatory Update

Apr 9, 2024

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

April 9, 2024, Issue #908

AHRQ Stats: Trends in Psychological Distress During the COVID-19 Pandemic

Between 2018 and 2021, the proportion of adults who reported experiencing psychological distress increased from 3.5 percent to 4.2 percent. However, among adults experiencing serious distress, the rate of outpatient mental health care decreased from 46.5 percent to 40.4 percent. (Source: Annals of Internal Medicine, Trends in Psychological Distress and Outpatient Mental Health Care of Adults During the COVID-19 Era.)

Today's Headlines:


Surge in Drug Shortages Occurred in Wake of Pandemic, Study Finds

drug shortagesA recent AHRQ-funded study on pharmaceutical supply chains revealed a significant spike in drug shortages during the COVID-19 pandemic. In the article, published in JAMA Network Open, researchers analyzed data from 2017 to 2021 and found that 13.7 percent of drugs with supply chain issues faced shortages and 6.4 percent were associated with severe shortages, compared with 4.1 percent for unaffected medications. Shortages peaked from February to April 2020, gradually decreasing after May 2020. Researchers said that injectable drugs, generics and essential World Health Organization medicines had lower odds of shortages. They urged continued policy effort to mitigate shortages and prepare pharmaceutical supply chains for future, unanticipated shocks. Access the abstract.
 

April 23 Webinar Will Highlight Advancements by National Action Alliance for Patient and Workforce Safety

National AllianceRegistration is open for a webinar on April 23 from noon to 1 p.m. ET to highlight progress made by the National Action Alliance for Patient and Workforce Safety. Established by AHRQ on behalf of the Department of Health and Human Services, the initiative is a collective effort of federal agencies and private partners to improve the safety of patients and the healthcare workforce across all healthcare delivery settings. Webinar speakers will discuss strategies for achieving 50 percent improvement in preventable harm to patients and healthcare workers. Funding opportunities, resources to improve safety and updates from federal partners will also be featured. Access more information about the National Action Alliance.
 

Now Available: Updated TeamSTEPPS 3.0 Pocket Guide App

TeamSTEPPSAHRQ has updated its Pocket Guide App for the TeamSTEPPS® 3.0 curriculum. TeamSTEPPS is designed to improve patient safety by training healthcare teams to communicate and practice effective teamwork. The app mirrors content in the pocket guide and provides quick reference to key TeamSTEPPS concepts and tools. Access the pocket guide and the app.   
 

Register Now: April 29 Virtual Grand Rounds To Highlight Making Healthcare Safer IV Report

MHCS reportA virtual Grand Rounds on April 29 from noon to 2 p.m. ET will highlight findings in AHRQ’s Making Healthcare Safer IV Report, a suite of rapid evidence reports on patient safety harms and practices. The Grand Rounds series highlights the work of AHRQ’s Evidence-based Practice Center (EPC) Program, which promotes and facilitates the use of evidence in healthcare decisions. The Grand Rounds will focus on awareness and implementation of findings in three reports:
Register now for the event, which will feature presentations from report authors and industry experts. Access previous Grand Rounds on topics including pain management, maternal health and telehealth.
 

Resources Help Manage Unhealthy Alcohol Use

alcoholDuring Alcohol Awareness Month, AHRQ is highlighting resources for clinicians to help patients struggling with alcohol use. Nearly 29 million adults had alcohol use disorder in 2022, according to the National Survey on Drug Use and Health. The AHRQ Academy’s searchable database provides nearly 600 resources for managing unhealthy alcohol use, including trainings and toolkits. An AHRQ guide answers primary care clinicians’ questions about prescribing medications to treat alcohol use disorder. Access information about AHRQ’s EvidenceNOW: Managing Unhealthy Alcohol Use Initiative, which is helping primary care practices implement screening, brief intervention and treatment referrals for patients with unhealthy alcohol use.
 

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:
Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Research Funding Opportunities From AHRQ

Health services researchers committed to improving the quality, safety and equity of healthcare can explore a variety of AHRQ funding opportunities to support this work. AHRQ has recently updated its research priorities guidance to include healthcare quality and safety; delivery and practice improvement; and whole-person healthcare delivery. Notice of Funding Opportunities include Research Grants (R series), Career Development Awards (K series) and Research Training and Fellowships (T & F series). Access more information on when to submit applications. Current notices include:

AHRQ in the Professional Literature


Policy solutions to eliminate racial and ethnic child health disparities in the USA. Jindal M, Barnert E, Chomilo N, et al. Lancet Child Adolesc Health. 2024 Feb;8(2):159-74. Access the abstract on PubMed®.

Adapting cognitive task analysis methods for use in a large sample simulation study of high-risk healthcare events. Militello LG, Salwei ME, Reale C, et al. J Cogn Eng Decis Mak. 2023 Dec;17(4):315-31. Epub 2023 Aug 4. Access the abstract on PubMed®.

Development of a novel telemedicine tool to reduce disparities related to the identification of preschool children with autism. Wagner L, Vehorn A, Weitlauf AS, et al. J Autism Dev Disord. 2023 Dec 8. [Epub ahead of print.] Access the abstract on PubMed®.
The association between food access and frailty among older adults with gastrointestinal malignancies-the CARE Registry. Fowler ME, Harmon C, Sharafeldin N, et al. Cancer. 2024 Apr 1;130(7):1083-91. Epub 2023 Dec 7. Access the abstract on PubMed®.

Mental health care provision in community health centers and hospital emergency department utilization. Carey K, Cole MB. Health Serv Res. 2024 Apr;59(2):e14283. Epub 2024 Jan 20. Access the abstract on PubMed®.
Adapting a community pharmacy intervention to improve medication safety. Berbakov ME, Hoffins EL, Stone JA, et al. J Am Pharm Assoc. 2024 Jan-Feb;64(1):159-68. Epub 2023 Nov 7. Access the abstract on PubMed®.
Continuous Medicaid eligibility during the COVID-19 pandemic and postpartum coverage, health care, and outcomes. Daw JR, MacCallum-Bridges CL, Kozhimannil KB, et al. JAMA Health Forum. 2024 Mar;5(3):e240004. Access the abstract on PubMed®.

Outcomes after initiation of medications for alcohol use disorder at hospital discharge. Bernstein EY, Baggett TP, Trivedi S, et al. JAMA Netw Open. 2024 Mar 4;7(3):e243387. Access the abstract on PubMed®.


Contact Information
For comments or questions about AHRQ News Now, contact Bruce Seeman, (301) 427-1998 or Bruce.Seeman@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