The Social Security Act requires a performance evaluation of each CMS-approved accrediting organizations(AO) to verify that the accredited provider demonstrate compliance with the Medicare Conditions of Participation (CoPs). The CMS annual report to Congress (RTC) details the review, validation and oversight of the AOs Medicare accreditation programs as well as those under Clinical Laboratory Improvement Amendments (CLIA).
The CMS evaluation process includes, but is not limited to, the following components:
• On-site observations are conducted to ensure that the accreditation program is fully implemented and operational
– Corporate on-site review
– Survey observation
• Comprehensive review of AO accreditation standards to ensure that the AO standards meet or exceed those of Medicare
• Comprehensive review of the AO’s
– Policies and procedures to ensure comparability with those of CMS
– Adequacy of resources to perform required surveys to ensure comparability with those of CMS
– Survey processes and enforcement to ensure comparability with those of CMS
– Surveyor evaluation and training to ensure comparability with those of CMS
– Electronic data to ensure the AO has the capacity to provide CMS with the necessary facility demographic, survey-related, deficiency, adverse action and accreditation decision data, etc.
– AO financial status to ensure organizational solvency and ability to support operations