Regulations/Legal

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November 2025
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Scrubs to startups: Turning caregiving expertise into entrepreneurial success

When Phyllis Quinlan, PhD, RN, NPD‑BC, founded MFW Consultants in 1994, she was already on her third career pivot. The former social‑work intern turned emergency‑trauma nurse discovered that the high-stakes of the emergency department (ED), coupled with her human‑behavior insights from sociology and psychology degrees, gave her a rare vantage point on how…

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By: Tarsilla Moura
August 27, 2025
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CMS’s plan to phase out inpatient-only list could bolster rural ASCs

Editor's Note The proposal from the Centers for Medicare & Medicaid Services (CMS) to eliminate the Medicare Inpatient Only (IPO) list over 3 years could significantly expand opportunities for ambulatory surgery centers (ASCs), with rural facilities among those positioned to benefit most, Ambulatory Surgery Center News August 12 reports. The…

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By: Tarsilla Moura
August 26, 2025
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AAAHC unveils v44 standards to sharpen focus on patient-centered ambulatory care

Editor's Note The Accreditation Association for Ambulatory Health Care (AAAHC) released its v44 Standards, introducing new guidance designed to strengthen patient-focused care, streamline compliance, and align with evolving state regulations, an August 18 AAAHC announcement reports. As detailed in the news release, the v44 Standards, effective December 16, 2025, were…

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By: Tarsilla Moura
August 26, 2025
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AST warns against fast-track training programs

Editor’s Note: This page is a companion piece to the main article, "Health systems embrace partnerships, new training pathways to address surgical technologist shortage."   The Association of Surgical Technologists (AST), a 55,000-member organization, acknowledges the growing shortage of surgical technologists (STs) but is raising alarms over the rise of…

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By: Anne Wainscott-Sargent
August 25, 2025
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Nursing demand drops in Q2 as healthcare hiring shifts toward physicians, pharmacy

Editor's Note Healthcare hiring slowed in the second quarter of 2025, with nursing and technician roles experiencing steep declines even as physician and pharmacy jobs continued to grow. According to HealthLeaders August 19, the shift signals a potential rebalancing in workforce priorities as hospitals and health systems adapt to financial…

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By: Tarsilla Moura
August 25, 2025
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Medicare Advantage patients see lower perioperative costs than traditional Medicare peers

Editor's Note Surgical episodes for Medicare Advantage (MA) patients cost less and used fewer resources than those for traditional Medicare (TM) beneficiaries, according to a JAMA Health Forum study published August 1. Researchers analyzed 1.18 million procedures performed on 1.11 million beneficiaries and found 30-day episode costs were 3.1% lower…

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By: Tarsilla Moura
August 25, 2025
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2026 ICD-10 updates bring hundreds of new codes, new complexity

Editor's Note Healthcare providers, payers, and analytics teams face sweeping ICD-10 changes this fall, with the 2026 code updates taking effect October 1, 2025, Wolters Kluwer July 14 reports. The release includes 614 new codes, 12 invalidations, 642 billability changes, 88 terminology revisions, and the creation of an entirely new…

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By: Tarsilla Moura
August 21, 2025
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Hospital-affiliated doctors drive highest costs by avoiding lower-cost sites

Editor's Note Patients treated by hospital-affiliated physicians are far less likely to receive specialty procedures in lower-cost settings, while private-equity–affiliated doctors are the most likely to steer patients toward these options, Ambulatory Surgery Center News August 12 reports. The findings come from a Mount Sinai study that examined physician affiliation,…

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By: Tarsilla Moura
August 20, 2025
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Largest US healthcare fraud case reveals billions in false Medicare, Medicaid claims and vast schemes nationwide

Editor's Note The US Department of Justice (DOJ) has conducted the largest healthcare fraud takedown in US history, charging 324 individuals, including 96 licensed medical professionals, in schemes totaling more than $14.6 billion, HealthCare Business News July 8 reports. The nationwide crackdown involved 50 federal districts and 12 state attorneys…

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By: Tarsilla Moura
August 19, 2025
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Mind the gap: Why Medicare pays ASCs less than HOPDs—and what that means

For decades, ambulatory surgery centers (ASCs) have shown their ability to deliver high-quality surgical care at substantially lower cost than hospital outpatient departments (HOPDs). ASCs achieve these savings through leaner operations, streamlined staffing models, and specialty-focused efficiencies, not by compromising safety or outcomes. Studies consistently highlight procedures performed in ASCs…

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By: Tarsilla Moura
August 19, 2025
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