Verma Raps Accrediting Organizations’ ‘Glaring Conflict of Interest’

By John Commins

Centers for Medicare & Medicaid Services Administrator Seema Verma took a swipe at accrediting organizations on February 25, noting that when they accept consulting fees from the hospitals they grade it creates “a glaring conflict of interest.”

Delivering the opening remarks at the 2020 CMS Quality Conference in Washington, D.C., Verma said her agency is “looking at ways to enhance our oversight of accrediting organizations.”

“You’re going to see more from us on this issue in the near future,” she said.

Verma said that CMS in recent years has found inconsistencies in the way accrediting organizations inspect providers.

“Some even use standards that differ from our own, which is simply not acceptable,” she said.

CMS in December 2018 put out a request for information from accrediting organizations that Verma says was designed to “ascertain the scope of the issue.”

On Tuesday, Verma did not name specific accrediting organizations in her critique, but she called “a spate of serious deficiencies” that included patient harm and deaths at hospitals that had been deemed Medicare compliant “deeply concerning.”

“Receiving CMS’s authorization to inspect and deem healthcare providers compliant with Medicare’s quality standards is nothing short of assuming a sacred public trust responsibility,” she said. “But an increasing amount of evidence indicates that accrediting organizations are not living up to that high bar.”

“Our concerns are not only heightened by the growing trend of accrediting organizations providing fee-based consulting services to the same organizations they accredit; a glaring conflict of interest,” Verma said, adding that CMS does not allow “these kinds of relationships” in other areas, such as Quality Improvement Organizations in Medicare or external reviews in Medicaid.

The Joint Commission, the nation’s largest hospital accrediting organization, has denied any conflict of interest, citing a “long-standing firewall” it has created between its accrediting division and its consulting division, Joint Commission Resources, Inc.

“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 accrediting organization said.

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.