Medicare Tightens Accrediting Organization Conflict Rules
Published Date: 6/16/2026
Rule
Summary
This new rule makes sure the groups that check Medicare providers play fair and follow clear rules to avoid conflicts of interest. It updates how psychiatric hospitals are reviewed and tightens rules for providers who lost their Medicare status but want back in. These changes affect Medicare providers and accrediting groups, start June 16, 2027, and aim to keep care safe and trustworthy.
Analyzed Economic Effects
6 provisions identified: 2 benefits, 4 costs, 0 mixed.
Stricter Re-entry Rules After Termination
If a Medicare-certified provider or supplier is involuntarily terminated from Medicare, CMS will no longer recognize that facility's AO accreditation for deemed compliance and the provider must meet the requirements of Sec. 489.57 before a new Medicare participation agreement is approved. While re-enrolling, the terminated provider will be placed under State Agency (SA) oversight for a 'reasonable assurance period' (length set by CMS) and may not rely on AO deeming while a new agreement is pending; AOs must terminate accreditation of such facilities within 5 business days of CMS written notice.
AOs Must Use Medicare Conditions
Accrediting organizations (AOs) that accredit Medicare-certified providers must use the language of the applicable Medicare Conditions of Participation, Conditions for Coverage, or Conditions for Certification as the minimum accreditation requirements. This change becomes effective June 16, 2027 and means AO accreditation must at least match Medicare rules even if the AO adds stricter requirements.
Limits on AO Fee-Based Consulting
AOs may not provide fee-based consulting to a healthcare provider before that provider's initial accreditation survey, and may not provide consulting within 12 months prior to the provider's next scheduled re-accreditation survey. AOs also may not provide consulting in response to a complaint, must keep firewall policies, and must report consulting activity to CMS on a bi-annual basis.
Psychiatric Hospital Survey Changes
CMS will integrate psychiatric hospital survey processes with acute care hospital surveys and requires AOs that currently accredit hospitals to expand their hospital programs to include psychiatric services. This change aims for systematic and integrated surveys of psychiatric hospital quality and safety.
Annual Surveyor Conflict Declarations
AOs must obtain and submit declarations from each surveyor disclosing any interests or relationships with healthcare providers they accredit, on at least an annual basis. When an AO owner, surveyor, or employee currently or within the previous 2 years has an interest or relationship with a facility, the AO must prevent that person from involvement in surveying or accreditation activities for that facility.
Public Plans of Correction & Validation
When an AO's performance on survey activities shows disparity concerns (via outcome or process disparity rates), the AO must submit a publicly reportable plan of correction. CMS is also expanding and revising AO validation survey types and requires AOs to provide survey findings to CMS under the revised rules.
Personalized for You
How does this regulation affect your finances?
Personalize government policy and PRIA will tell you what this federal register document means for your household, plus every other regulation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.
Key Dates
Department and Agencies
Related Federal Register Documents
2026-15686, Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
This final rule updates the hospice wage index, payment rates, and aggregate cap amount for fiscal year 2027. This final rule also includes an analysis of Medicare non-hospice spending, including details regarding a hospice service and spending variation index, and finalizes the requirement that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election. Additionally, this rule finalizes conforming changes to discharge from hospice care regulations and changes to the face-to-face encounter regulations. This final rule also includes a summary of comments received on our requests for information regarding community- based palliative care; the construction of a hospice specific wage index; and the overlap between hospice and medical aid in dying laws. Finally, this rule finalizes changes to the Hospice Quality Reporting Program.
2026-15652, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality Reporting Program
This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2027. As required by statute, this final rule includes the classification and weighting factors for the IRF prospective payment system's (PPS) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2027. It also finalizes the third and final of the 3-year phaseout of the rural adjustment, which began in FY 2025. This final rule includes a solicitation for public comments on alternative data sources for the IRF PPS wage index; requires all therapy treatments and/or therapy evaluations to begin no later than 36 hours from midnight on the day of admission; finalizes requirements for the initial Interdisciplinary Team meeting to occur on or before 4 days from the date the patient is admitted; and summarizes a request for information on potential future IRF PPS payment reform. Additionally, this final rule includes updates to the IRF Quality Reporting Program and changes to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.
2026-15562, Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2027
Starting October 1, 2026, skilled nursing facilities (SNFs) will see updated payment rates and new rules for how Medicare pays them. The Quality Reporting and Value-Based Purchasing programs are also getting tweaks to help improve care. These changes affect SNFs nationwide and could impact how much money they get and how they report quality data.
2026-14897, Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes
Starting October 1, 2026, new rules will change how states handle health care-related taxes under Medicaid. These changes set clear limits on tax amounts based on 2025 levels and will gradually lower those limits in some states by 2027. States and taxpayers should get ready for tighter rules and better oversight that could affect tax collections and Medicaid funding.
2026-14709, Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program; Correction
This correction fixes some typos and technical mistakes in the 2027 health insurance rules under the Affordable Care Act. It mainly affects people and organizations involved in health coverage plans by clarifying when the rules take effect and restoring some important regulation details. These fixes take effect on July 20, 2026, ensuring smoother and clearer health plan operations next year.
2026-14327, Medicare and Medicaid Programs; CY 2027 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
Starting in 2027, Medicare and Medicaid are updating how doctors and clinics get paid to better match today’s medical care and laws. This includes new rules for drug price rebates, shared savings programs, and payments for rural and specialty care. These changes affect doctors, patients, and drug makers, aiming to save money and improve care quality.
Previous / Next Documents
Previous: 2026-12067, Fee Schedules; Fee Recovery for Fiscal Year 2026
The Nuclear Regulatory Commission is updating its fees for licenses, inspections, and special projects starting August 17, 2026. These changes make sure the NRC covers nearly all its costs while setting clear fee limits to keep prices predictable and fair. If you hold a license or apply for one, expect some fee adjustments that help the NRC run smoothly and efficiently.
Next: 2026-12071, International Mailing Services: Price Changes
Starting July 12, 2026, the Postal Service is updating prices for international mail. Postcards will cost $1.75 worldwide, and some letter and flat rates are changing too. Plus, they’re dropping the Customs Clearance and Delivery Fee for certain inbound mail, making things simpler and sometimes cheaper for senders and receivers around the globe.