CMS proposes sweeping changes to oversight and consulting practices for accrediting organizations in response to concerns regarding inconsistent survey results and conflicts of interest. The proposed rule aligns accrediting organizations with state survey agencies, limits consulting services, prohibits access to survey records, mandates reporting of conflicts of interest, and requires correction plans for poor performance. These measures aim to improve the integrity and effectiveness of the accreditation process, ensuring healthcare facilities meet stringent quality standards. Dr. Shawn Griffin of URAC supports the proposed changes, emphasizing the importance of accreditation as a rigorous test of quality. The public comment period, running from February 15 to April 15, invites stakeholders to provide feedback on the proposed rule before finalization.
CMS is addressing concerns regarding the consistency of survey results and conflicts of interest in the healthcare accreditation process. In response, the agency has proposed significant changes aimed at enhancing oversight and transparency. These changes include aligning accrediting organizations with state survey agencies, restricting consulting services, and mandating reporting of conflicts of interest. The proposed rule seeks to strengthen the integrity of the accreditation process and ensure that healthcare facilities meet stringent quality standards. Dr. Shawn Griffin of URAC voices support for the proposed changes, emphasizing the importance of accreditation in upholding healthcare quality.
Accrediting organizations play a crucial role in ensuring that healthcare providers and suppliers adhere to the health and safety standards set by CMS. However, recent instances of inconsistent survey results and conflicts of interest have raised red flags for the agency. These concerns have been brought to light through various channels, including media reports, performance evaluations, and direct observations.
In its proposed rule, CMS aims to address these issues by implementing several key measures:
1. Alignment with State Survey Agencies: CMS proposes holding accrediting organizations to the same standards as state survey agencies. This move seeks to ensure consistency and coherence in survey practices and outcomes.
2. Limitations on Consulting Services: Recognizing the potential conflict of interest, CMS suggests placing restrictions on fee-based consulting services offered by accrediting organizations to healthcare facilities seeking accreditation. This measure aims to maintain the integrity of the accreditation process and prevent undue influence.
3. Prohibition of Access to Survey Records: The proposed rule prohibits individuals associated with accrediting organizations, including owners, surveyors, employees, and close relations, from accessing survey records of the facilities they accredit. This step aims to prevent any bias or undue advantage in the accreditation process.
4. Reporting Requirements: Accrediting organizations would be required to report conflicts of interest to CMS, ensuring transparency and accountability in their operations.
5. Correction Plans for Poor Performance: CMS proposes that accrediting organizations with subpar performance submit correction plans to address identified deficiencies. This measure aims to improve the overall quality and effectiveness of accrediting organizations.
6. Enhanced Alignment and Training: CMS seeks to enhance alignment between accrediting organizations and state survey agencies in terms of survey activity requirements and staff training, promoting consistency and efficiency in the survey process.
Additionally, the proposed rule aims to reduce burdens on providers by cutting down on look-back validation surveys. These surveys, which validate previous survey results, would be reduced by half, alleviating administrative burdens on healthcare facilities.
The proposed changes would impact all nine accrediting organizations approved by CMS, except those accrediting clinical laboratories and noncertified suppliers.
Dr. Shawn Griffin, President and CEO of the Utilization Review Accreditation Commission (URAC), expressed strong support for the proposed rule, particularly emphasizing the focus on conflicts of interest. He highlighted the importance of accreditation as a rigorous test of quality and underscored URAC’s commitment to avoiding conflicts of interest in the accreditation process.
The proposed rule is set to be published in the Federal Register on February 15, with a public comment period open until April 15. This timeline allows stakeholders and interested parties to provide feedback and insights on the proposed changes before they are finalized.
CMS’s proposed rule marks a significant step towards improving oversight and accountability in healthcare accreditation. By addressing concerns surrounding inconsistent survey results and conflicts of interest, the proposed changes aim to bolster the integrity and effectiveness of the accreditation process. Stakeholders, including accrediting organizations, healthcare providers, and the public, have the opportunity to provide feedback during the public comment period. Dr. Shawn Griffin’s endorsement underscores the importance of maintaining rigorous quality standards in healthcare. Ultimately, the proposed rule sets the stage for a more transparent and robust accreditation system, ensuring that patients receive care from facilities that meet the highest standards of quality and safety.