WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services has finalized new regulations designed to strengthen oversight of healthcare accrediting organizations, a move the agency says will improve patient safety, reduce conflicts of interest and ensure more consistent enforcement of Medicare standards across more than 9,000 healthcare providers and suppliers.
The rule targets accrediting organizations, or AOs, which inspect healthcare facilities and determine whether they meet federal requirements for participation in Medicare and Medicaid programs. CMS said the changes are intended to align accreditor practices more closely with those used by state survey agencies and strengthen accountability for organizations entrusted with evaluating healthcare quality and safety.
Under the final rule, accrediting organizations will be required to use standards that meet or exceed Medicare requirements and follow survey processes that more closely mirror those used by state inspectors.
CMS is also establishing a new performance-monitoring system for accrediting organizations, updating validation and oversight procedures, and requiring accreditor surveyors to complete the same CMS training required of state survey agency surveyors.
The agency said the changes are designed to address longstanding concerns about inconsistencies in accreditation practices and potential conflicts of interest involving consulting services provided by some accrediting organizations.
One provision prohibits accrediting organizations from conducting mock surveys for facilities they accredit before an initial accreditation survey and during the 12 months following re-accreditation. CMS said the restriction is intended to preserve the independence and objectivity of the accreditation process.
The final rule also codifies a requirement that accreditation surveys be conducted without advance notice, bringing accreditor practices into alignment with existing CMS survey policies.
CMS Administrator Dr. Mehmet Oz said the rule is intended to strengthen public confidence in healthcare oversight.
“The work accrediting organizations do is vital, but it also raises an age-old question: who watches the watchmen? The answer is, we do,” Oz said. “With this new rule, CMS is advancing its commitment to upholding rigorous standards for accrediting organizations and ensuring the health and safety of American patients.”
Federal officials said variability among accreditation standards and survey methods has sometimes resulted in inconsistent findings and enforcement actions among Medicare-certified facilities.
By establishing Medicare participation requirements as the baseline standard for accreditation reviews, CMS said the rule is intended to promote greater consistency in evaluating healthcare providers while reinforcing expectations for safe and effective patient care.
The agency also said the changes will streamline portions of the accreditation validation process, reducing administrative burdens on state survey agencies, accrediting organizations and healthcare providers.
The final rule is available through the Federal Register at https://www.federalregister.gov/.
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