More than 15,000 physician offices and standalone imaging centers have been accredited since the CMS began requiring the certifications last year, following a 2008 congressional mandate. The requirement applies only to providers that bill for Medicare Part B physician services, not hospitals.
The report found widely varying accreditation methods. In particular, the GAO found that the Joint Commission, one of the three accrediting agencies, tends not to enforce all the standards that would be expected of an accredited provider of advanced imaging, while charging much higher fees than the other two groups.
Joint Commission officials were not available for comment Friday. In written comments to the GAO, the Joint Commission took strong exception to how the auditors evaluated the accreditors, saying flawed methodology led to an incomplete view of the work being done.
The other two accrediting groups—the American College of Radiology and the Intersocietal Accreditation Commission—both evaluated all nine areas that GAO said were relevant to investigate and yet charged fees as low as one-sixth the fees charged by the Joint Commission's.
The IAC has accredited 8,491 providers of advanced imaging, ACR has done 6,855, and the Joint Commission has done 98, the report says.
Pam Wilcox, assistant executive director for quality and safety at ACR, said her group was pleased that the GAO had done the review, and that she's looking forward to reading a second report from the agency due out next year that will have even more depth.
“I think it just really emphasizes the need to have consistent standards for all providers, as opposed to the variability that exists,” Wilcox said. She cited in particular differences in how the accrediting agencies evaluate the qualification of personnel and the quality of the images produced.
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