Obligations of AOs with Deeming Authority

40.4 - Obligations of AOs with Deeming Authority (Rev. 117, Issued: 08-08-14, Effective: 08-08-14, Implementation: 08-08-14) 42 CFR §422.157 AOs must apply and enforce the standards that CMS determines, as a condition of approval, are at least as stringent as the applicable Medicare requirements. To be approved, an AO must comply with the application and reapplication procedures that are addressed in section 40.4.1 of this chapter. To prevent conflicts of interest, AOs must ensure the following: • When the AO deems an MAO, any individual associated with the AO who is also associated with the MAO, does not influence the deeming decision concerning that MAO; • That the majority of the membership of the AOs governing body is not comprised of managed care organizations or their representatives; • The AOs governing body acts without bias and has a broad and balanced representation of interests. To avoid actual conflicts of interests (or the appearance of conflicts of interests), CMS encourages any personnel involved in a conflict to recuse themselves from the deeming process for the MAO in conflict. Additionally, if CMS takes an adverse action based on accreditation findings, the approved AO must permit its surveyors to serve as witnesses.