CMS Final Rule on PSOs taking effect Jan. 1

Under a Final Rule issued by the Centers for Medicare & Medicaid Services (CMS) taking effect Jan. 1, 2017, health insurance plans certified by the Health Insurance Marketplace may only contract with hospitals (of greater than 50 beds) that either:

• Work with a Patient Safety Organization (PSO); or
• Meet the reasonable exception criteria by implementing an evidence-based initiative to improve health care quality through the collection, management and analysis of patient safety events.

CMS has confirmed that membership in a Quality Improvement Organization (QIO), Hospital Engagement Network (HEN), or Joint Commission accreditation will qualify as a reasonable equivalent. Learn more here.