[Federal Register: January 24, 2003 (Volume 68, Number 16)]
[Notices]
[Page 3532-3534]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr24ja03-80]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-2177-PN]
RIN 0938-AM38
Medicare and Medicaid Programs; Application by the Joint
Commission on Accreditation of Healthcare Organizations (JCAHO) for
Hospices
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Proposed notice.
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SUMMARY: This proposed notice announces the receipt of an application
from the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO) for continued recognition as a national accreditation program
for hospices that wish to participate in the Medicare or Medicaid
programs. The Social Security Act requires that within 60 days of
receipt of an organization's complete application, the Secretary
publish a notice identifying the national accreditation body making the
request, describing the nature of the request, and providing at least a
30-day public comment period.
DATES: We will consider comments if we receive them at the appropriate
address, as provided below, no later than 5 p.m. on February 24, 2003.
ADDRESSES: In commenting, please refer to file code CMS-2177-PN.
Because of staff and resource limitations, we cannot accept
comments by facsimile (FAX) transmission. Mail written comments (one
original and three copies) to the following address only: Centers for
Medicare & Medicaid Services, Department of Health and Human Services,
Attention: CMS-2177-PN, P.O. Box 8013, Baltimore, MD 21244-8013.
Please allow sufficient time for mailed comments to be timely
received in the event of delivery delays.
If you prefer, you may deliver (by hand or courier) your written
comments (one original and three copies) to one of the following
addresses: Room 443-G, Hubert H. Humphrey Building, 200 Independence
Avenue, SW., Washington, DC 20201, or Room C5-14-03, 7500 Security
Boulevard, Baltimore, MD 21244-1850.
Comments mailed to the addresses indicated as appropriate for hand
or courier delivery may be delayed and could be considered late.
For information on viewing public comments, see the beginning of
the SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT: Cindy Melanson, (410) 786-0310.
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments: Comments received timely will be
available for public inspection as they are received, generally
beginning approximately 3 weeks after publication of a document, at the
headquarters of the Centers for Medicare & Medicaid Services, 7500
Security Boulevard, Baltimore, Maryland 21244, Monday through Friday of
each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view
public comments, phone (410) 786-7197.
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number and expiration
[[Page 3533]]
date. Credit card orders can also be placed by calling the order desk
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This Federal Register document is also available from the Federal
Register online database through GPO Access, a service of the U.S.
Government Printing Office. The Web site address is: http://www.access.gpo.gov/nara/index.html
.
I. Background
Under the Medicare program, eligible beneficiaries may receive
covered services in a hospice provided certain requirements are met.
Section 1861 (dd)(1) of the Social Security Act (the Act) establishes
distinct criteria for facilities seeking designation as a hospice
program. Regulations concerning provider agreements are at 42 CFR part
489, and those pertaining to activities relating to the survey and
certification of facilities are at 42 CFR part 488. In 42 CFR part 418,
we specify the conditions that a hospice must meet in order to
participate in the Medicare program, the scope of covered services, and
the conditions for Medicare payment for hospice care.
Generally, to enter into an agreement, a hospice facility must
first be certified by a State survey agency as complying with our
conditions or requirements. Following that certification, the hospice
is subject to routine monitoring by a State survey agency to ensure
continuing compliance. As an alternative to surveys by State agencies,
section 1865(b)(1) of the Act provides that, if the Secretary finds
that, through accreditation by a national accreditation body, a
provider entity demonstrates that all of our applicable conditions and
requirements are met or exceeded, the Secretary will deem that the
provider entity has met the applicable Medicare requirements.
Accreditation by an accreditation organization is voluntary and is not
required for Medicare participation.
Section 1865(b)(1) of the Act provides that, if a provider entity
demonstrates through accreditation by an approved national
accreditation organization that all applicable Medicare conditions are
met or exceeded, CMS shall ``deem'' those provider entities as having
met the requirements. Section 1865(b)(2) of the Act further requires
that the Secretary's findings concerning review and reapproval as a
recognized accreditation program for hospices consider the reapplying
accreditation organization's--
[sbull] Requirements for accreditation;
[sbull] Survey procedures;
[sbull] Ability to provide adequate resources for conducting
required surveys;
[sbull] Ability to supply information for use in enforcement
activities;
[sbull] Monitoring procedures for provider entities found out of
compliance with the conditions or requirements; and
[sbull] Ability to provide the Secretary with necessary data for
validation.
Section 1865(b)(3)(A) of the Act requires that the Secretary
publish a notice within 60 days of receipt of a written request; the
notice must--
[sbull] Identify the national accreditation body making the
request;
[sbull] Describe the nature of the request; and
[sbull] Provide at least a 30-day public comment period.
In addition, we must publish a finding of approval or denial of the
application within 210 days from the receipt of the completed request.
Our regulations concerning reapproval of accrediting organizations
are set forth at Sec. 488.4 and Sec. 488.8(d)(3). Our regulations
require accreditation organizations to reapply for continued approval
of deeming authority every 6 years or sooner, as we determine.
JCAHO's term of approval as a recognized accreditation program for
hospices expires June 18, 2003.
The purpose of this proposed notice is to inform the public of our
consideration of JCAHO's request for approval of continued deeming
authority for hospices. This notice also solicits public comment on the
ability of JCAHO requirements to meet or exceed the Medicare conditions
for participation for hospices.
II. Evaluation of Deeming Authority Request
On November 26, 2002, JCAHO submitted all the necessary materials
to enable us to make a determination concerning its request for
reapproval as a deeming organization for hospices. Under section
1865(b)(2) of the Act and our regulations at Sec. 488.8 (Federal
review of accreditation organizations), our review and evaluation of
JCAHO will be conducted in accordance with, but not necessarily limited
to, the following factors:
[sbull] The equivalency of JCAHO standards for hospice care as
compared with our comparable hospice conditions of participation as
described in our regulations at Sec. 418.1 through Sec. 418.405.
[sbull] JCAHO's survey process to determine the following:
--The composition of the survey team, surveyor qualifications, and the
ability of the organization to provide continuing surveyor training.
--The comparability of JCAHO processes to those of State agencies,
including survey frequency, and the ability to investigate and respond
appropriately to complaints against accredited facilities.
--JCAHO's processes and procedures for monitoring providers or
suppliers found out of compliance with JCAHO program requirements.
These monitoring procedures are used only when JCAHO identifies
noncompliance. If noncompliance is identified through validation
reviews, the survey agency monitors corrections as specified at Sec.
488.7 (d).
--JCAHO's capacity to report deficiencies to the surveyed facilities
and respond to the facility's plan of correction in a timely manner.
--JCAHO's capacity to provide us with electronic data in ASCII
comparable code, and reports necessary for effective validation and
assessment of the organization's survey process.
--The adequacy of JCAHO's staff and other resources, and its financial
viability.
--JCAHO's capacity to adequately fund required surveys.
--JCAHO's policies with respect to whether surveys are announced or
unannounced.
--JCAHO's agreement to provide us with a copy of the most current
accreditation survey together with any other information related to the
survey as we may require (including corrective action plans).
III. Response to Public Comments and Notice Upon Completion of
Evaluation
Because of the large number of items of correspondence we normally
receive on Federal Register documents published for comment, we are not
able to acknowledge or respond to them individually. We will consider
all comments we receive by the date and time specified in the DATES
section of this preamble and will respond to the public comments in the
preamble to that document.
Upon completion of our evaluation, including evaluation of comments
received as a result of this notice, we will publish a final notice in
the Federal Register announcing the result of our evaluation.
In accordance with the provisions of Executive Order 12866, the
Office of Management and Budget did not review this proposed notice.
Authority: Section 1865 of the Social Security Act (42 U.S.C.
1395bb)
[[Page 3534]]
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program; No. 93.773 Medicare--Hospital Insurance Program;
and No. 93.774, Medicare--Supplementary Medical Insurance Program)
Dated: January 16, 2003.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 03-1589 Filed 1-23-03; 8:45 am]