CMS Examines Possible Conflicts of Interest in Accrediting Organizations

Federal regulators are asking for public comment and cite 'disparity rates' between state audits and AO reviews of healthcare facilities.

The Centers for Medicare & Medicaid Services is asking questions about potential conflicts of interest between Medicare accrediting organizations and the healthcare facilities they monitor.

"We are concerned that the practice of offering both accrediting and consulting services–and the financial relationships involved in this work–may undermine the integrity of accrediting organizations and erode the public’s trust," CMS Administrator Seema Verma said in a media release.

"Our data shows that state-level audits of healthcare facilities are uncovering serious issues that AOs have missed, leading to high 'disparity rates' between the two reviews," Verma said.

"We are taking action across-the-board to ensure the quality and safety of patient care through strengthened CMS oversight of AOs, and today's RFI is a critical component of that effort."

The query likely will include an examination of The Joint Commission, the nation's largest hospital accrediting organization. In a media statement, The Joint Commission said it is reviewing CMS's requests for comment, but said it is confident in the integrity of the "firewall" between its consulting and accrediting divisions.

"The Joint Commission recognizes the importance of assuring the integrity of the accreditation process, which we accomplish by prohibiting any sharing of information about consulting services for individual organizations with anyone involved in accreditation," the statement read.

"The Joint Commission as an accrediting organization and Joint Commission Resources, Inc. as a provider of education and consulting services are two separate organizations. The Joint Commission enterprise has long-standing firewall policies, practices and procedures in place that assure that this goal is achieved," the statement read.