CMS takes steps to beef up oversight of accrediting organizations

CMS has proposed a new rule that aims to improve transparency around accrediting organizations (AOs) that certify healthcare facilities in the Medicare program. Specifically, the rule creates a new process for AOs to follow if there is a sale, transfer or purchase of assets in the ownership of the organization.

The move follows the agency’s rising interest in AO oversight. In October 2018, CMS announced a new pilot test to observe the ability of AOs to assess healthcare providers and require the organizations to publicly post more information about the performance of healthcare facilities they review. The action followed an investigation by The Wall Street Journal in 2017 that found some AOs had continued to grant Medicare certification to healthcare facilities with documented patients' care problems.

CMS also sought input from industry stakeholders at the end of 2018 on potential conflicts of interest between AOs and the facilities they monitor.

The new proposed rule changes current regulations that AOs are not required to notify CMS of pending changes of ownership. AOs have deeming authority from CMS, giving them the authority to affirm that a healthcare facility has met the health and safety standards of Medicare. Under current rules, CMS is only notified of a change in AO ownership when the organization applies for renewal of its agreement to CMS or gives the information to the agency voluntarily.

“Accrediting Organizations are an important partner in our oversight of healthcare facilities across the country,” CMS Administrator Seema Verma said in a statement. “Today we are reinforcing our commitment to patient safety by proposing policy that would require Accrediting Organizations to notify CMS when the organization makes a change in ownership.”

The rule would require AOs to submit to CMS when they are contemplating or negotiating a change in ownership, according to the announcement. Prospective new owners would also be required to submit documentation and information about their ability to effectively perform the required accreditation tasks.

“CMS’s proposal does not impede the actual sale of an AO, but instead gives CMS the ability to approve or deny the accreditation programs that are to be transferred as part of the sale or transfer,” the notice reads.

See the proposed rule here.