[Federal Register: August 22, 2008 (Volume 73, Number 164)]
[Notices]
[Page 49681-49683]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr22au08-72]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[CMS-2899-PN]
Medicare and Medicaid Programs; Application by the Accreditation
Commission for Health Care for Continued Deeming Authority for Home
Health Agencies
AGENCY: Centers for Medicare and Medicaid Services, HHS.
ACTION: Proposed notice.
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SUMMARY: This proposed notice acknowledges the receipt of a deeming
application from the Accreditation Commission for Health Care (ACHC)
for continued recognition as a national accrediting organization for
home health agencies (HHAs) 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.
DATES: To be assured consideration, comments must be received at one of
the addresses provided below, no later than 5 p.m. d.s.t. on September
21, 2008.
ADDRESSES: In commenting, please refer to file code CMS-2899-PN.
Because of staff and resource limitations, we cannot accept comments by
facsimile (FAX) transmission.
You may submit comments in one of four ways (please choose only one
of the ways listed):
1. Electronically. You may submit electronic comments on this
regulation to http://www.regulations.gov. Follow the instructions for
``Comment or Submission'' and enter the file code to find the document
accepting comments.
2. By regular mail. You may mail written comments (one original and
two copies) to the following address ONLY:
Centers for Medicare & Medicaid Services, Department of Health and
Human Services, Attention: CMS-2899-PN, P.O. Box 8013, Baltimore, MD
21244-8013.
Please allow sufficient time for mailed comments to be received
before the close of the comment period.
3. By express or overnight mail. You may send written comments (one
original and two copies) to the following address ONLY:
Centers for Medicare & Medicaid Services, Department of Health and
Human Services, Attention: CMS-2899-PN, Mail Stop C4-26-05, 7500
Security Boulevard, Baltimore, MD 21244-1850.
4. By hand or courier. If you prefer, you may deliver (by hand or
courier) your written comments (one original and two copies) before the
close of the comment period to either of the following addresses:
a. Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue,
SW., Washington, DC 20201.
(Because access to the interior of the Hubert H. Humphrey (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.)
b. 7500 Security Boulevard, Baltimore, MD 21244-1850.
If you intend to deliver your comments to the Baltimore address,
please call telephone number (410) 786-9994 in advance to schedule your
arrival with one of our staff members.
Comments mailed to the addresses indicated as appropriate for hand
or courier delivery may be delayed and received after the comment
period.
For information on viewing public comments, see the beginning of
the ``SUPPLEMENTARY INFORMATION'' section.
FOR FURTHER INFORMATION CONTACT: Lillian Williams, (410) 786-8636;
Patricia Chmielewski, (410) 786-6899.
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments: All comments received before the
close of the comment period are available for viewing by the public,
including any personally identifiable or confidential business
information that is included in a comment. We post all comments
received before the close of the comment period on the following Web
site as soon as possible after they have been received: http://
www.regulations.gov. Follow the search instructions on that Web site to
view public comments.
Comments received timely will also 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 1-800-743-3951.
I. Background
Under the Medicare program, eligible beneficiaries may receive
covered services from a home health agency (HHA) provided certain
requirements are met. Sections 1861(m) and (o), and 1891 of the Social
Security Act (the Act) authorize the Secretary to establish distinct
criteria for facilities seeking designation as an HHA. 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 part 488. The regulations at part 484 specify the
conditions that an HHA must meet in order to participate in the
Medicare
[[Page 49682]]
program, the scope of covered services and the conditions for Medicare
payment for home health care.
Generally, in order to enter into an agreement with the Medicare
program, an HHA must first be certified by a State survey agency as
complying with the conditions or requirements set forth in part 484.
Thereafter, the HHA is subject to regular surveys by a State survey
agency to determine whether it continues to meet these requirements.
There is an alternative to surveys by State agencies, which is
accreditation.
Section 1865(b)(1) of the Act provides that, if an HHA demonstrates
through accreditation by an approved national accrediting organization
that all applicable Medicare conditions are met or exceeded, we will
deem those HHAs as having met the requirements. Accreditation by an
accrediting organization is voluntary and is not required for Medicare
participation.
If an accrediting 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 accrediting organization applying for
deeming authority under part 488, subpart A must provide us with
reasonable assurance that the accrediting organization requires the
accredited provider entities to meet requirements that are at least as
stringent as the Medicare conditions. Our regulations concerning the
reapproval of accrediting organizations are set forth at Sec. 488.4
and Sec. 488.8(d)(3). Section 488.8(d)(3) requires accrediting
organizations to reapply for continued deeming authority every 6 years
or sooner as determined by us.
In the February 24, 2006 Federal Register (71 FR 9564), we
published a final notice announcing our decision to approve the
Accreditation Commission for Health Care (ACHC) as a recognized
accreditation program for HHA's. ACHC's term of approval expires
February 24, 2009.
II. Approval of Deeming Organizations
Section 1865(b)(2) of the Act and Sec. 488.8(a) of the regulations
require that our findings concerning review and reapproval of a
national accrediting organization's requirements consider, among other
factors, the applying accrediting organization's: Requirements for
accreditation; survey procedures; resources for conducting required
surveys; capacity to furnish information for 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 organization's complete application, a
notice identifying the national accrediting body making the request,
describing the nature of the request, and providing at least a 30-day
public comment period. We have 210 days from the receipt of a complete
application to publish notice of approval or denial of the application.
The purpose of this proposed notice is to inform the public of
ACHC's request for continued deeming authority for HHAs. This notice
also solicits public comment on whether ACHC's requirements meet or
exceed the Medicare conditions of participation for HHAs.
III. Evaluation of Deeming Authority Request
ACHC submitted all the necessary materials to enable us to make a
determination concerning its request for reapproval as a deeming
organization for HHAs. This application was determined to be complete
on June 27, 2008. Under section 1865(b)(2) of the Act and Sec. 488.8
of the regulations (Federal review of accrediting organizations), our
review and evaluation of ACHC will be conducted in accordance with, but
not necessarily limited to, the following factors:
The equivalency of ACHC's standards for an HHA as compared
with CMS's HHA conditions of participation.
ACHC'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 ACHC's processes to those of State
agencies, including survey frequency, and the ability to investigate
and respond appropriately to complaints against accredited facilities.
++ ACHC's processes and procedures for monitoring HHAs found out of
compliance with ACHC's program requirements. These monitoring
procedures are used only when ACHC identifies noncompliance. If
noncompliance is identified through validation reviews or complaint
surveys, the State survey agency monitors corrections as specified at
Sec. 488.7(d).
++ ACHC's capacity to report deficiencies to the surveyed
facilities and respond to the facility's plan of correction in a timely
manner.
++ ACHC's capacity to provide us with electronic data and reports
necessary for effective validation and assessment of the organization's
survey process.
++ The adequacy of ACHC's staff and other resources, and its
financial viability.
++ ACHC's capacity to adequately fund required surveys.
++ ACHC's policies with respect to whether surveys are announced or
unannounced, to assure that surveys are unannounced.
++ ACHC'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).
IV. Response to Public Comments and Notice Upon Completion of
Evaluation
Because of the large number of public comments we normally receive
on Federal Register documents, 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, when we proceed with a subsequent document, we will respond to the
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.
V. Collection of Information Requirements
This document does not impose information collection and
recordkeeping requirements. Consequently, it need not be reviewed by
the Office of Management and Budget under the authority of the
Paperwork Reduction Act of 1995 (44 U.S.C. 35 et seq. ).
VI. Regulatory Impact Statement
In accordance with the provisions of Executive Order 12866
(September 1993, Regulatory Planning and Review, the Regulatory
Flexibility Act (RFA) (September 19, 1980, Pub. L. 96-354), the Office
of Management and Budget did not review this proposed notice.
In accordance with Executive Order 13132, we have determined that
this proposed notice would not have a significant effect on the rights
of States, local or tribal governments.
Authority: Section 1865 of the Social Security Act (42 U.S.C.
1395bb).
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance
[[Page 49683]]
Program; No. 93.773 Medicare--Hospital Insurance Program; and No.
93.774, Medicare--Supplementary Medical Insurance Program)
Dated: August 7, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E8-18971 Filed 8-21-08; 8:45 am]
BILLING CODE 4120-01-P