CMS Finalizes Changes To Requirements for Accrediting Organizations

The Centers for Medicare & Medicaid Services on June 12 issued a final rule revising its oversight of accrediting organizations that evaluate hospitals and other health care providers for compliance with Medicare’s Conditions of Participation. The rule is intended to reduce provider burden, foster greater consistency in AO survey processes and strengthen AO conflict-of-interest requirements.

Among other provisions, the final rule:

• Phases out traditional “look-back” validation surveys and adopts direct observation validation surveys in which state survey agencies accompany AO surveyors to evaluate their performance.
• Prohibits AOs from giving hospitals or other facilities any advance notice of a survey or identifying survey “blackout” dates.
• Requires AOs to align their minimum standards with Medicare CoPs and provide a crosswalk demonstrating that alignment.
• Restricts certain AO consulting services in the 12 months before an accreditation survey.
• Requires AOs to adopt conflict-of-interest policies for surveyors and other staff.
• Requires terminated providers to demonstrate compliance through a state agency survey before CMS will approve a new Medicare participation agreement.

The final rule’s policies take effect June 16, 2027.