The Centers for Medicare & Medicaid Services (CMS) has finalized a new rule aimed at strengthening how it oversees Accrediting Organizations (AOs), the bodies responsible for checking whether healthcare providers meet health and safety standards. The rule, titled "Strengthening Oversight of AOs and Preventing AO Conflicts of Interest," applies to more than 9,000 healthcare providers and suppliers currently reviewed by CMS-approved AOs.

AOs are organizations that inspect and accredit hospitals and other healthcare facilities on behalf of CMS. When a facility earns accreditation from an approved AO, it is considered to automatically meet federal Medicare or Medicaid requirements, a status known as "deemed" status. But CMS has had growing concerns over how well AOs have been performing this role.

CMS Administrator Dr. Mehmet Oz addressed the issue directly, saying the work AOs do is vital, but someone has to watch over them too, and that is exactly what this rule is designed to do.

Among the biggest concerns CMS had before issuing this rule were providers keeping their accreditation even after being removed from Medicare or Medicaid for safety violations, AOs offering paid consulting services to the same facilities they were supposed to be independently inspecting, and AOs tipping off facilities about upcoming survey visits, which goes against CMS policy.

The new rule tackles all of these problems. It prohibits AOs from conducting mock surveys for providers they accredit before initial surveys and within 12 months of re-accreditation. It also blocks AO owners, employees, and their immediate family members from being involved in any survey where they have a personal or financial connection to the facility being reviewed.

Going forward, all accreditation surveys must be conducted without advance notice to the facility being inspected, bringing AO practices in line with what state survey agencies already do.

The rule also introduces a brand new performance monitoring process. AOs that score poorly on performance evaluations will now be required to submit a correction plan to CMS, which will be made available to the public. AO surveyors will also be required to complete the same CMS training that state surveyors go through, helping create more consistent results across the board.

The goal across all these changes is to make sure that whether a facility is inspected by a state agency or a private AO, the standards being applied and the process being followed are the same. CMS says the rule will also reduce the overall administrative burden on providers and make AO practices more transparent.

The final rule is available on the Federal Register at federalregister.gov. A full fact sheet can also be found on the CMS website.