The Centers for Medicare & Medicaid Services released a proposed rule to strengthen oversight of accrediting organizations (AOs).
The proposed rule responds to several AO performance concerns the agency identified, including inconsistent survey results and conflicts of interest related to fee-based consulting services AOs provide to the providers and suppliers they accredit. If finalized, the rule would increase oversight of AOs, reduce conflicts of interest, and strive for enhanced consistency of survey processes, all of which aim to improve patient safety and quality of care.
Currently, CMS has approved nine AOs to survey and accredit Medicare-certified facilities. The changes in the proposed rule affect all AOs except those that accredit clinical laboratories and noncertified suppliers.
The proposed changes, which align with CMS’ National Quality Strategy, include:
- Holding AOs accountable to the same standards as state survey agencies.
- Ensuring that AOs remain independent reviewers by targeting conflicts of interest and limiting the fee-based consulting services AOs provide to the health care facilities they accredit.
- Preventing AO conflicts of interest by prohibiting AO owners, surveyors, and other employees with an interest in or relationship with a health care facility the AO accredits, as well as their immediate family members, from survey participation, input on survey results and involvement in pre- or post-survey activities of that facility, or access to the facility’s survey records.
- Targeting potential and actual conflicts of interest by requiring AOs to report specific information to CMS about how they will monitor, prevent, and handle conflicts of interest and fee-based consulting services they provide.
Additional proposed changes would reduce the burden on providers, strengthen survey policies, and increase the transparency of AO practices.
Comments on this proposed rule were due April 15.
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.
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