An analysis published Friday by the Government Accountability Office found that the Centers for Medicare & Medicaid Services has not established clear standards for the three organizations--the American College of Radiology (ACR), the Intersocietal Accreditation Commission (ICA) and the Joint Commission--that accredit providers of magnetic resonance imaging, computed tomography, or positron-emission tomography.
According to the report, while CMS has adopted the broad criteria from the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) for ADI accreditation, it relied on the three accrediting organizations it selected to establish their own standards for quality and safety, standards that have differed significantly among the three organizations.
In order to establish a framework for assessing advanced diagnostic imaging standards now in use, GAO developed a list of nine standards based on recommendations from 11 organizations with imaging expertise. According to GAO, ACR and ICA use all nine standards, while the Join Commission uses six of the nine standards.
"As a result of these significant differences among the accrediting organizations, which arise from the lack of minimum national standards, important aspects of imaging, such as qualifications of technologists and medical directors and the quality of clinical images, are difficult for CMS to monitor and assess," the GAO report states.
GAO recommends that CMS determine the content of and publish minimum national standards for the accreditation of ADI suppliers; develop an oversight framework for evaluating accrediting organization performance; and develop more specific requirements for accrediting organization audits and clarify guidance on immediate-jeopardy deficiencies.
"If accreditation is actually going to achieve a national standard of quality and safety for patients, there have to be legitimate, meaningful standards in place," Paul H. Ellenbogen, chair of the American College of Radiology Board of Chancellors, said in a statement in support of the analysis. "Today's GAO report is a significant step in the right direction. The ACR looks forward to working with Congress, HHS, and other stakeholders to put the GAO recommendations into action."