CMS Final Regulations for Accrediting Organizations0

The following e-Bulletin was published by the California State Bar, Business Law Section, on May 21, 2015.

CMS issued its proposed final regulations for accrediting organizations, revising the survey, certification and enforcement procedures relating to CMS oversight of entities such as the Joint Commission and the Healthcare Facilities Accreditation Program. These revisions implement provisions under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), as well as clarify CMS’ oversight of these accrediting organizations.

In general, providers and suppliers of health care services must be substantially in compliance with certain statutory requirements before participating in the Medicare program. These obligations are known as “conditions of participation” (CoPs) for hospitals and most providers, “requirements” for skilled nursing facilities, and “conditions for coverage” (CfCs) for ambulatory surgical centers. Failure to meet the standards set forth by CMS may compromise a provider’s ability to participate in the Medicare Program.

Following the April 5, 2013 proposed regulations, the final regulations accomplish, in part, the following:

  1. Confirm CMS’ standards to the MIPPA revisions.
  2. Clarify and reorganize existing regulations, eliminate potentially confusing and unnecessary duplication.
  3. Strengthen CMS’s ability to oversee the 21 CMS-approved accrediting organizations.

The text of these final regulations can be found here.

 

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