Commentary |

Improving the Rules for Hospital Participation in Medicare and Medicaid

Patrick H. Conway, MD, MSc; Donald M. Berwick, MD, MPP
JAMA. 2011;306(20):2256-2257. doi:10.1001/jama.2011.1611.
Text Size: A A A
Published online


The hospital “conditions of participation” establish the quality and safety standards that all US hospitals must follow to participate in the Medicare and Medicaid programs. The conditions of participation are the basis for onsite surveys that determine if a hospital meets the standards for accreditation. Such accreditation surveys are conducted by the Centers for Medicare & Medicaid Services (CMS), the Joint Commission, state survey agencies, and others.1 The CMS can terminate hospital provider agreements that have been found to be out of compliance with the conditions of participation, thus making hospitals ineligible for payment by the Medicare and Medicaid programs. Since updated in 1986, the last major change to the conditions of participation was attempted in 1997, but failed due to more than 60 000 public comments and dissenting opinions.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles