The Centers for Medicare & Medicaid Services June 12 issued a final rule revising how the agency conducts oversight of accrediting organizations that ensure that hospitals and other healthcare providers are in compliance with the Medicare Conditions of Participation. To reduce burden on providers, the final rule phases out the use of “look-back” validation surveys, replacing them with direct observation validation surveys in which state agencies accompany AOs on surveys to directly evaluate their work. The rule also implements several policies intended to improve consistency in the survey process, including requiring AOs to match their baseline standards with the CoPs and provide a crosswalk of those standards with the CoPs. It also requires AO surveyors to take the same basic training courses as state agency surveyors and implements several conflict-of-interest policies for AOs, including certain restrictions on fee-based consulting services. The changes will take effect June 16, 2027.

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The Department of Health and Human Services Office of Inspector General June 11 released two reports on high rates of coverage denials by Medicare Advantage…
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The Hospital Insurance Trust Fund has been projected to become insolvent in 2033, according to the Medicare Board of Trustees’ annual report released June 9.…
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Members of Congress and hospital and health system leaders today gathered for a briefing in Washington, D.C., to discuss how payment delays in Medicare…
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The Centers for Medicare & Medicaid Services May 28 issued a final rule making changes to the Increasing Organ Transplant Access Model beginning July 1.…
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Approximately 35 million Americans are enrolled in Medicare Advantage plans in 2026, and that number is expected to grow to about 45 million MA enrollees by…
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The Centers for Medicare & Medicaid Services has released details on downloading its upcoming fiscal year 2025 Program for Evaluating Payment Patterns…