On June 16, 2026, the Centers for Medicare & Medicaid Services (CMS) released a
final rule with comment period that includes provisions to strengthen the oversight of Medicare national accrediting organizations (AO) by addressing conflicts of interest, establishing consistent standards, processes, and definitions, and updating the validation and performance standards systems.
Some of the key changes to CMS’ AO requirements include:
- Holding AOs accountable to the same Medicare standards and strengthening comparability of survey processes to those of state survey agencies that also conduct surveys on behalf of CMS.
- Ensuring that AOs remain independent reviewers by addressing conflicts of interest and placing certain limitations on the fee-based consulting services AOs provide to the healthcare facilities they accredit.
- Preventing AO conflicts of interest by prohibiting AO owners, surveyors, and other employees, as well as their immediate family members that have an interest in or relationship with a healthcare facility accredited by the AO, from participating in surveys, having input into the survey results and involvement in pre- or post-survey activities of that facility, and from having access to survey records related to that facility.
- Improving AO performance by requiring AOs with unacceptable performance measure scores, determined through a direct observation validation survey by CMS (a new process for monitoring AO performance established as a requirement in this rule), to submit a publicly reported correction plan to CMS.
- Improving consistency and standardization in surveys nationwide by more closely aligning AO survey activity requirements and staff training with those of SAs.
These regulations are effective as of June 16, 2027. To be assured comments are considered, comments on sections VI., “Collection of Information” and VII., “Regulatory Impact Analysis” must be received at one of the addresses
listed here by August 17, 2026.
