Medicare Compliance & Reimbursement

The Gallup Organization polling firm has filed suit against Centers for Medicare & Medicaid Services Administrator Tom Scully, alleging that Scully tried to bully one of its partners out of pursuing a complaint about CMS's handling of the hospital consumer-satisfaction survey it is developing. In a March 5 e-mail asserting that Gallup was trying to do an end run around CMS by asking an Office of Management and Budget Official to intervene on its behalf, Scully referred to Gallup managing partner Robert Neilsen as a "jerk" and an "idiot."

"You are such a weasel that you won't come discuss this with me like a normal person," Scully wrote, in a correspondence that Gallup says is part of a "willful and malicious campaign" to violate Gallup's and Nielsen's "constitutional rights of free speech, free association and due process."

The flap has its roots in a meeting early last year between the Agency for Healthcare Research and Quality and another firm that conducts patient-satisfaction surveys, NRC/Picker, as AHRQ was beginning to develop a hospital survey. At the time, the planned AHRQ survey was a research initiative without broad monetary implications.

Trouble began shortly thereafter, however, when CMS announced that it would partner with AHRQ on the hospital survey, in connection with the new voluntary quality-reporting initiative that was being pushed by the American Hospital Association and others. The CMS-backed survey likely will be used for mandatory public reporting of satisfaction data and perhaps even be used to partially determine Medicare payments, CMS announced, making the issue of which vendors were involved in the instrument's development a matter of intense financial interest to companies that currently provide satisfaction surveys.

In a Federal Register notice last summer, CMS solicited comments on hospital patient-satisfaction measures from interested parties and received comments from Gallup and other firms in addition to NRC/Picker. CMS officials have met with most survey firms in recent months.

CMS and AHRQ say they are developing the new survey on their own and will not contract with a specific vendor either to develop or administer it. Gallup, however, complains that NRC/Picker's early meeting with AHRQ and other subsequent contacts between federal officials and NRC/Picker unfairly give that firm an inside track for eventual business connected to the survey.

But in a Web site notice apparently intended to assure they hospital clients that they can stick with current vendors, another survey firm, Press Ganey Associates, Inc., declares that "this government survey, developed by AHRQ, is totally new to the industry rather than being an adaptation of any vendor's existing survey. ... Per CMS, it is meant to be used for public accountability and not performance improvement." Hospitals currently use vendors' surveys as quality-improvement tools.