Press release

CMS Proposes to further strengthen oversight of Accrediting Organizations

CMS Proposes to further strengthen oversight of Accrediting Organizations
Proposed rule will increase transparency of changes of ownerships to safeguard patient safety

The Centers for Medicare & Medicaid Services (CMS) today announced a proposed rule that would assure continued quality and safety in healthcare facilities by requiring greater transparency when ownership changes occur at Accrediting Organizations (AOs). The proposed rule establishes a specific process AOs with Medicare-approved accreditation programs must follow if there is a sale, transfer, and/or purchase of assets related to the ownership of an AO, in order to ensure the ongoing effectiveness of approved accreditation programs. Today’s proposal builds on recent work by the agency to strengthen the oversight of AOs and enhance transparency of AO performance.

“Accrediting Organizations are an important partner in our oversight of healthcare facilities across the country,” said CMS Administrator Seema Verma. “Today we are reinforcing our commitment to patient safety by proposing policy that would require Accrediting Organizations to notify CMS when the organization makes a change in ownership. This rule builds on earlier steps we’ve take to strengthen federal oversight of Accrediting Organizations and ensure patients are receiving high quality, safe care at our nation’s healthcare facilities.” 

CMS is responsible for providing continued oversight of AOs’ Medicare accreditation programs to ensure that providers or suppliers accredited by each AO meet the required quality and patient safety standards. CMS grants AOs “deeming authority,” which means that AOs are allowed to affirm that a facility’s health and safety standards meet or exceed those of Medicare. Only facilities and suppliers that have been deemed by state or AO surveyors to meet CMS’ standards may receive payments from Medicare.

Current CMS regulations governing AOs do not require them to provide CMS advanced notice of pending changes of ownership. CMS is first notified of an AO ownership change when an AO, under new leadership, applies for renewal of its agreement to CMS or it voluntarily notifies the agency.

This proposal would require AOs to notify CMS when they are contemplating or negotiating a change of ownership. CMS would also require prospective new owners to submit documentation and information confirming their ability to effectively perform the required accreditation tasks after the change of ownership takes place. CMS’s proposal does not impede the actual sale of an AO, but instead gives CMS the ability to approve or deny the accreditation programs that are to be transferred as part of the sale or transfer.

Today’s proposal is only the latest in a series of actions CMS has taken to improve its oversight of AOs. In 2018, CMS announced it would begin posting AO performance data online and also began a more streamlined, efficient way to assess AOs’ ability to ensure that facilities and suppliers comply with CMS requirements. The agency also issued a Request for Information (RFI) seeking comment on the financial relationships between CMS-approved AOs and the healthcare facilities they review and monitor. As part of this process, CMS will determine whether revisions should be made to the AO application and renewal process to identify actual, potential, or perceived conflicts of interest.

If finalized, this rule would give CMS the ability to conduct better oversight through increased transparency of the ongoing effectiveness of approved accreditation programs that may undergo a change of ownership, thereby minimizing any potential risks to patient safety and further building on the agency’s commitment to patient safety and accountability.

To view the proposed rule (CMS-3368-P), please visit:


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