[Federal Register: April 25, 2003 (Volume 68, Number 80)]
[Notices]
[Page 20391-20393]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr25ap03-50]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-2182-PN]
Medicare and Medicaid Programs; Application by the Community
Health Accreditation Program (CHAP) for Continued Approval of Deeming
Authority for Hospices
AGENCY: Centers for Medicare & Medicaid Services, HHS.
ACTION: Proposed notice.
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SUMMARY: This proposed notice acknowledges the receipt of an
application from the Community Health Accreditation Program (CHAP) for
continued recognition as a national accreditation program for hospice
facilities that wish to participate in the Medicare or Medicaid
programs. Section 1865(b)(3)(A) of the Social Security Act (the Act)
requires that within 60 days of receipt of an organization's complete
application, we publish a notice that identifies the national
accrediting body making the request, describes the nature of the
request, and provides at least a 30-day public comment period.
[[Page 20392]]
DATES: We will consider comments if we receive them at the appropriate
address, as provided below, no later than 5 p.m. on May 27, 2003.
ADDRESSES: In commenting, please refer to file code CMS-2182-PN. Due to
staff and resource limitations, we cannot accept comments by facsimile
(fax). Mail written comments (one original and three copies) to the
following address: Centers for Medicare and Medicaid Services,
Department of Health and Human Services, Attention: CMS-2182-PN, P.O.
Box 8013, Baltimore, MD 21244-8013.
Please allow sufficient time for mailed comments to be 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 (HHH) Building, 200
Independence Avenue, SW., Washington, DC 20201, or Room C5-14-03, 7500
Security Boulevard, Baltimore, MD 21244-1850.
(Because access to the interior of the HHH Building is not readily
available to persons without Federal Government identification,
commenters are encouraged to leave their comments in the CMS drop slots
located in the main lobby of the building. A stamp-in clock is
available for persons wishing to retain a proof of filing by stamping
in and retaining an extra copy of the comments being filed.)
Comments mailed to the above addresses indicated as appropriate for
hand or courier delivery may be delayed and received too late for us to
consider them.
For information on viewing public comments, see the beginning of
the SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT: Cindy Melanson, (410) 785-0310.
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 of Medicare &
Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244,
Monday through Friday of each week from 8:30 a.m. to 4 p.m. Top
schedule an appointment to view public comments, phone (410) 786-7195.
I. Background
Under the Medicare program, eligible beneficiaries may receive
covered services in a hospice, provided certain requirements are met.
Section 1861(dd) of the Social Security Act (the Act) establishes
distinct criteria for facilities seeking designation as a hospice
provider. Provider agreement regulations are located in 42 CFR part
489, and regulations pertaining to activities relating to the survey
and certification of facilities are located in 42 CFR part 488. The
regulations at 42 CFR part 418 specify the conditions that a hospice
facility must meet in order to participate in the Medicare program, the
scope of covered services, and the conditions for Medicare payment for
hospice care. Section 1905(O)(1)(A) of the Act generally extends their
requirements to payments for hospice services under the Medicaid
program.
Generally, in order to enter into an agreement, a hospice facility
must first be certified by a State survey agency as complying with the
conditions or requirements set forth in part 418 of our regulations.
Then, the hospice facility is subject to regular surveys by a State
survey agency to determine whether it continues to meet these
requirements. There is an alternate, however to surveys by State
agencies.
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, we would ``deem'' those provider entities as having
met the requirements. Accreditation by an accreditation organization is
voluntary and is not required for Medicare participation.
If an accreditation organization is recognized by the Secretary as
having standards for accreditation that meet or exceed Medicare
requirements, any provider entity accredited by the national
accrediting body's approved program would be deemed to meet the
Medicare conditions. A national accreditation organization applying for
approval of deeming authority under part 486, subpart A must provide us
with reasonable assurance that the accreditation organization requires
the accredited provider entities to meet requirements that are at least
as stringent as the Medicare conditions. Our regulations concerning
reapproval of accrediting organizations are set forth at Sec. 488.4
and Sec. 488.8(d)(3). The regulations at Sec. 488.8(d)(3) require
accreditation organizations to reapply for continued approval of
deeming authority every 6 years or sooner as determined by us. The
Community Health Accreditation Program's (CHAP's) term of approval as a
recognized accreditation program for hospice facilities expires
November 20, 2003.
II. Approval of Deeming Organizations
Section 1965(b)(2) of the Act and our regulations at Sec. 488.8(a)
require that our findings concerning review and reapproval of a
national accrediting organization's requirements consider, among other
factors, the reapplying accreditation organization's: Requirements for
accreditation; survey procedures; resources for conducting required
surveys; capacity to furnish information to use in enforcement
activities; monitoring procedures for provider entities found not in
compliance with the conditions or requirements; and ability to provide
us with the necessary data for validation.
Section 1865(b)(3)(A) of the Act further requires that we publish,
within 60 days of receipt of an accreditation organization's complete
application, 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. In addition, we must publish a
notice in the Federal Register or our approval or denial of the
application within 210 days from the receipt of the application.
The purpose of this proposed notice is to inform the public of our
consideration of CHAP's request for approval of continued deeming
authority for hospice facilities. This notice also solicits public
comment on whether CHAP requirements meet or exceed the Medicare
conditions for participation for hospice facilities.
III. Evaluation of Deeming Authority Request
On February 21, 2003, CHAP submitted all the necessary materials to
enable us to make a determination concerning its request for reapproval
as a deeming organization for hospice facilities. 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
CHAP will be conducted in accordance with, but not necessarily limited
to, the following factors:
[sbull] The equivalency of CHAP standards for hospice care as
compared with our comparable hospice conditions of participation.
[sbull] CHAP'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 CHAP processes to that of State agencies,
including survey frequency, and the ability to investigate and respond
appropriately
[[Page 20393]]
to complaints against accredited facilities.
--CHAP's processes and procedures for monitoring providers or suppliers
found out of compliance with CHAP program requirements. These
monitoring procedures are used only when CHAP identifies noncompliance.
If noncompliance is identified through validation reviews, the survey
agency monitors corrections as specified at Sec. 488.7(d).
--CHAP's capacity to report deficiencies to the surveyed facilities and
respond to the facility's plan of correction in a timely manner.
--CHAP 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 CHAP's staff and other resources, and its financial
viability.
--CHAP's capacity to fund required surveys.
--CHAP's policies with respect to whether surveys are announced or
unannounced.
--CHAP's agreement to provide us with a copy of the most current
accreditation survey together with any other information relate to the
survey as we may require (including corrective action plans).
IV. Response to Public Comments and Notice Upon Completion of
Evaluation
Due to the large number of items of correspondence we normally
receive a 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, this
notice was not reviewed by the Office of Management and Budget.
Authority: Section 1965 of the Social Security Act (42 U.S.C.
1395bb) (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: April 8, 2003.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 03-9496 Filed 4-24-03; 8:45 am]
BILLING CODE 4120-01-M