The House Committee on Energy and Commerce is conducting oversight to ensure that hospitals participating in Medicare and Medicaid meet certain patient safety standards, prompted by concerns that the Centers for Medicare and Medicaid Services isn't providing adequate accreditation oversight of its own.
At issue are discrepancies between state survey agencies, which conduct Medicaid certification and inspect hospitals to determine whether they meet the conditions of participation, and the CMS-approved accrediting organizations that act as an alternative to do the same job.
The U.S. Department of Health and Human Services, through CMS, conducts oversight of its own to ensure accreditation requirements are being met. But in a letter to CMS Administrator Seema Verma, the House committee expressed concerns about the rigor of the CMS oversight, particularly when it came to accrediting organizations. The largest currently operating AO is the Joint Commission.
Specifically, the committee cited a fiscal year 2015 annual report from CMS showing that AOs conducting hospital surveys failed to report 39 percent of "condition level" deficiencies that were later reported by state survey agencies following validation surveys. The surveys from the state survey agencies occurred within 60 days of the AOs' assessments in these cases.
CMS's definition of a "condition level" deficiency is "the most serious type of deficiency cited, indicating a provider or supplier is not in compliance with an entire (condition of participation), according to the letter.
Giving CMS a deadline of March 23, the House committee requested several documents, including copies of contracts between CMS and state survey agencies, and any correspondence that may pertain to the disparities in validation surveys from those agencies and AOs.
The House committee letter was signed by Committee on Energy and Commerce Chairman Greg Walden, Subcommittee on Oversight and Investigations Chairman Gregg Harper and Subcommittee on Health Chairman Michael Burgess, MD.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com