Stark legislation targets JCAHO’s governing board
Sources close to Rep. Pete Stark (D-CA) say the congressman believes that the recently released government report on the state of hospital accreditation all but ensures that Congress will take some sort of legislative action to address deficiencies identified by the Health and Human Services’ Office of Inspector General (OIG).
Stark’s own bill, the Improvement of Medicare Accrediting Entity Act of 1999, introduced in June, well in advance of the OIG report, is de-signed to reduce conflicts of interest in accrediting agencies that review quality standards for Medicare-participating hospitals. Stark argues that, specifically with regard to the Joint Com-mission on Accreditation of Healthcare Organi-zations (JCAHO), a "serious conflict of interest" exists between JCAHO’s accreditation mission and its internal governance, given that most of the members of its board are representatives of the industry.
Stark’s bill would require that a simple majority of an accrediting agency’s governing board consist of individuals approved by the secretary of Health and Human Services. Those individuals would be required to have no financial interest in the accrediting agency or any of the facilities the agency accredits. The bill also stipulates that meetings of the governing board be open to the public.
"There needs to be some pretty strong reworking of JCAHO in order to make it truly an effective agency at ensuring the quality of hospitals," says an aide to Stark. "[The OIG report] is just one more instance where the facts show that there’s too cozy a relationship between the Joint Commission and the industry."
Janet McIntyre, a JCAHO spokeswoman, notes that the composition of the Joint Commission’s board already has changed dramatically over the last 10 years. For example, since 1996, the Joint Commission dropped the controversial practice of charging industry experts a $20,000 fee for the privilege of sitting on the agency’s board. Additionally, McIntyre says, fully one-fourth of the board now consists of public appointees. "We think that there needs to be a balance between public representatives and experts from the health care field to help guide [JCAHO] in a very complicated process," she says.
Stark’s aide says the publication of the OIG report dramatically improves the bill’s chance of passage this year.
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