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CMS: Accrediting orgs can keep survey reports private

Hospital Safety Insider, August 10, 2017

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Proposal that would have forced publication of detailed reports dropped due to clause in federal law

A proposal by CMS to require accrediting organizations (AO) to post the details of their survey reports online was withdrawn last week by the agency, not because of negative comments—although there were plenty—but because, well, it might be prohibited under federal law.

The proposal first came in April, tucked into the latter pages of the always-long proposed changes to the CMS Inpatient Prospective Payment System (IPPS) for the upcoming fiscal year.

The idea was to make AOs post final survey reports online within 90 days of the information being made available to the relevant hospital (or other health care organization). The public versions would include details of all initial and recertification surveys at that provider for the preceding three years, plus accepted plans of correction. Currently, an AO discloses only whether or not an organization is accredited; detailed findings are not made public.

The proposal had aimed to promote transparency in healthcare, CMS argued, noting that it posts its own survey reports online. But critics contended the CMS reports are made available in a hard-to-read spreadsheet and that the federal agency was responsible for far fewer surveys at healthcare organizations, oftentimes only after a complaint. In the end, though, it was a fresh reading of the law, not this criticism, that halted the proposal.

In its IPPS final rule, published August 2, CMS noted that it would not proceed with its proposed changes to the federal regulations governing application and re-application procedures for national AOs—which means CMS backed away from its proposed requirement that AOs post their detailed reports publicly.

“Section 1865(b) of the Act prohibits CMS from disclosing survey reports or compelling the AOs to disclose their reports themselves,” the final rule states. “The suggestion by CMS to have the AOs post their survey reports may appear as if CMS was attempting to circumvent the provision of section 1865(b) of the Act. Therefore, this provision is effectively being withdrawn.”

In public comments to CMS concerning the proposal, The Joint Commission (TJC) said that requiring survey details be made public would have a “chilling effect” on efforts to raise standards of quality.

“There will be a race to the bottom on quality as health care organizations seek out oversight bodies that will report on the least number of standards comparable to the Medicare requirements,” Mark R. Chassin, MD, FACP, MPP, MPH, TJC’s president and CEO, wrote. “This may also lead to a growth in non-accredited facilities that will then be surveyed at taxpayer expense and with fewer oversight visits.”

Other groups similarly weighed in against the proposal.

A version of this article originally appeared in Inside the Joint Commission.

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