Denied claims for urgent, medically necessary procedures are no laughing matter. Patient access staff have to appeal each denial, a time-consuming and expensive process. A New York law states that if a patient presents with unexpected complications or requires additional services in the course of treatment, a health insurer will no longer be able to deny payment due to lack of prior authorization.
The antivaccine movement is lobbying state legislatures to widen exemptions against childhood school immunizations and other mandates. As infection preventionists, the Association for Professionals in Infection Control and Epidemiology has taken on the fight.
New research indicates that for Texas providers and patients, the 2016 Food and Drug Administration’s (FDA) new labeling for the abortion drug mifepristone increased access options and brought the proportion of medication abortions in the state into alignment with national data.
At Memorial Hermann Texas Medical Center in Houston, quality professionals are well aware of the importance of getting an outside perspective. "When you are in the midst of the forest, you can't see some of the processes that have become a habit to you," says Angela Lenox, the hospital's peer review manager.
The continuing publicity surrounding both ever increasing public financial support for clinical research and claims of improper human research activities has led to calls for additional oversight of the clinical research enterprise.