CMS Seeks Public Comment on Accrediting Organizations and Conflicts of Interest

PUBLISHED: Dec 19, 2018
Relevant to: All Healthcare Organizations

The U.S Centers for Medicare and Medicaid Services is seeking comment on accreditation organizations and conflicts of interest. CMS has issued a Request for Information (RFI) seeking comment on the financial relationships between CMS-approved Accrediting Organizations (AOs) and the healthcare facilities they review and monitor. Some AOs provide consulting services to the facilities they monitor and charge fees for these services. CMS’ RFI is seeking input on whether these consulting fees create conflicts of interest, as the same entity is both consulting for a given facility and monitoring whether that facility is accredited to participate in Medicare.

CMS approves Accrediting Organizations whose accreditation standards meet or exceed Medicare’s quality and safety requirements. State agencies conduct follow-on reviews of select facilities to audit AO surveys, and a significant number of state audits have uncovered issues that AOs missed. The high “disparity rate” between state audits and AO reviews has led CMS to undertake a comprehensive analysis of its oversight of AOs. In addition to accrediting facilities, some AOs also provide consulting services, such as the following:

  • Assisting clinical and non-clinical leaders, including administrators, in understanding standards for compliance;
  • Reviewing a healthcare facility’s processes, policies, and functions;
  • Identifying and providing technical assistance for changing areas in need of improvement; and
  • Providing a simulation of a real survey, to include comprehensive written reports of findings, in advance of the AO’s formal survey.

According the CMS, the information received through this RFI will assist in developing potential future rulemaking or guidance. As part of this process, CMS will determine whether revisions should be made to the AO application and renewal process to identify actual, potential, or perceived conflicts of interest.

Follow the link below to review the Request for Information and for comment submission instruction. Comments will for sixty days after the RFI is published in the Federal Register.

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