Congressional leaders concerned with lax federal oversight of accrediting organizations

Patients in a hospital waiting room
Investigations into accrediting organizations' reticence to strip accreditation from hospitals that fail to meet CMS standards have legislators questioning the agency's oversight functions. (Image: Getty/SuwanPhoto)

Congressional leaders on the Energy and Commerce Committee want more information about the Centers for Medicare & Medicaid Services' oversight of accrediting organizations.

In a letter (PDF) to CMS Administrator Seema Verma, the committee said it wants to make sure that hospitals that participate in Medicare and Medicaid programs adhere to federal standards and make efforts to ensure patient safety. The letter was signed by Energy and Commerce Committee Chairman Greg Walden, R–Ore., Oversight and Investigations Subcommittee Chairman Gregg Harper, R–Miss., and Health Subcommittee Chairman Michael C. Burgess, M.D., R–Texas.

RELATED: Investigation—Joint Commission rarely revokes accreditation from hospitals that put patients at risk

The questions come in the wake of a Wall Street Journal investigation last September that found that the Joint Commission rarely ends up revoking hospitals’ accreditation, even when those hospitals fall out of compliance with CMS standards.

By statute, hospitals that participate in Medicare must meet a minimum set of standards known as Conditions of Participation (CoPs). Hospitals that receive accreditation from an independent accrediting organization (AO) approved by CMS can use that accreditation to demonstrate compliance with the CoPs. Given the apparent ease with which some facilities have received such accreditation, Congressional leaders have raised questions about the agency’s oversight of the independent organizations offering accreditation.

RELATED: Hospital Impact—Why hospitals should rethink the accreditation process

“Although CMS has worked to strengthen its oversight of AOs, the committee is concerned about the adequacy of CMS’ oversight as well as the rigor of the accrediting organization survey process,” wrote the committee leaders. They point out that 39% of “condition level” deficiencies turned up by state survey agencies doing validation surveys following an accreditor inspection were never reported by the AO. 

The committee also send separate letters to the Joint Commission (PDF), the Bureau of Healthcare Facilities Accreditation (PDF), the Center for Improvement in Healthcare Quality (PDF) and DNV GL Healthcare (PDF) asking about their survey process.

RELATED: Grassley urges feds to find a way to make hospital accreditation reports public

In a follow-up article, the Wall Street Journal reports that the Joint Commission sees its focus as preventing problems rather than taking punitive action, which explains its reticence to withdraw accreditation. The article also notes that accreditation inspection reports are not currently available to the public, something that  Sen. Chuck Grassley, R-Iowa, chairman of the Senate Judiciary Committee, has advocated for and has asked  CMS to look into what it would take to force public disclosure of the reports.