Other Facilities Quality Regulation

VII. Key Issues: Regulation & Reform >> B. Health Care Regulation >> Health Facilities Regulation >> Other Facilities Quality Regulation


Medicare and Medicaid are important payers for many other types of health facilities and services. Medicare and Medicaid Conditions of Participation (COPs) establish a guaranteed floor of quality for such patients across states regardless of the extent to which states regulate quality in such facilities. There are disparate Medicare COPs across different types of facilities. In some cases these include mandatory data reporting requirements. Other facilities with COPs include ambulatory surgical centers, diagnostic imaging agencies, pharmacies, ambulances, and renal dialysis centers. The Duke Center for Health Policy and Inequalities Research has developed a draft working paper assessing the costs and benefits of other health facilities quality regulation (pdf). The paper assesses various topics including:

  • Medicare conditions of participation for:

o Ambulatory Surgical Centers
o Diagnostic Imaging Centers
o Home Health Agencies
o Renal Dialysis Centers
o Pharmacies
o Ambulances

  • State accreditation and licensure

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