The Centers for Medicare & Medicaid Services (CMS) published a final rule to enhance oversight of accrediting organizations (AOs). The rule, “Strengthening Oversight of AOs and Preventing AO Conflicts of Interest,” ensures that the organizations responsible for the oversight of healthcare providers and suppliers use Medicare standards, and creates greater consistency between State Survey Agencies (SAs) and AOs. The changes will reduce provider burden, strengthen survey policies, and increase transparency, CMS said.
The final rule is designed to:
- Ensure AO accreditation standards continue to meet or exceed those of the Medicare program
- Align accreditation and survey processes with CMS requirements
- Confirm AO enforcement of CMS requirements
- Reinforce that all accredited entities must deliver safe, effective care
- Prevent AO conflicts of interest that may arise from related consulting services
Additionally, the rule creates a new process for monitoring AO performance; establishes consistent standards, processes, and definitions; updates validation and performance systems; requires AO surveyors to take the same CMS training as SA surveyors; and reduces the burden on SAs, AOs, and providers by streamlining the CMS AO validation process.
Certified facilities, whether surveyed by state agencies or AOs, must meet the same health and safety standards, and the rule requires accreditation surveys be conducted without advance notice, ensuring consistency with previously established CMS policy.
CMS said the rule addresses longstanding concerns by prohibiting AOs from conducting mock surveys for providers they accredit before initial surveys and within 12 months of reaccreditation. This prohibition helps ensure consulting activities do not compromise the objectivity and integrity of the accreditation process. Additionally, CMS said, variability in accreditation standards has led to inconsistent survey findings and enforcement across Medicare-certified facilities.
To read the Fact Sheet, visit the CMS website.
