[Federal Register: June 26, 2009 (Volume 74, Number 122)]
[Notices]
[Page 30588-30590]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr26jn09-80]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-2302-PN]
Medicare and Medicaid Programs; Application by the Joint
Commission for Continued Deeming Authority for Hospitals
AGENCY: Centers for Medicare & Medicaid Services, HHS.
ACTION: Proposed notice.
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SUMMARY: This proposed notice acknowledges the receipt of a deeming
application from the Joint Commission for continued recognition as a
national accrediting organization for hospitals that wish to
participate in the Medicare or Medicaid programs. The statute requires
that we publish within 60 days of receipt of an organization's complete
application, 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. on July 27, 2009.
ADDRESSES: In commenting, please refer to file code CMS-2302-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
[[Page 30589]]
the instructions under the ``More Search Options'' tab.
2. By regular mail. You may mail written comments to the following
address ONLY: Centers for Medicare & Medicaid Services, Department of
Health and Human Services, Attention: CMS-2302-PN, P.O. Box 8010,
Baltimore, MD 21244-1850.
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 to
the following address ONLY: Centers for Medicare & Medicaid Services,
Department of Health and Human Services, Attention: CMS-2302-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 before the close of the comment period
to either of the following addresses:
a. For delivery in Washington, DC--Centers for Medicare & Medicaid
Services, Department of Health and Human Services, Room 445-G, Hubert
H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC
20201.
(Because access to the interior of the Hubert H. Humphrey 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. For delivery in Baltimore, MD--Centers for Medicare & Medicaid
Services, Department of Health and Human Services, 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 FURTHER INFORMATION CONTACT: Cindy Melanson, (410) 786-0310.
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 hospital provided certain requirements are met.
Section 1861(e) of the Social Security Act (the Act) establishes
distinct criteria for facilities seeking designation as a hospital.
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. The regulations at 42 CFR part
482 specify the conditions that a hospital must meet in order to
participate in the Medicare program, the scope of covered services and
the conditions for Medicare payment for hospitals.
Generally, in order to enter into a provider agreement with the
Medicare program, a hospital must first be certified by a State survey
agency as complying with the conditions or requirements set forth in
part 482 of our regulations. Thereafter, the hospital is subject to
regular surveys by a State survey agency to determine whether it
continues to meet these requirements. There is an alternative, however,
to surveys by State agencies.
Section 1865(a)(1) of the Act (as re-designated under section 125
of the Medicare Improvements for Patients and Providers Act of 2008
(MIPPA) (Pub. L. 110-275)) provides that, if a provider entity
demonstrates through accreditation by an approved national accrediting
organization that all applicable Medicare conditions are met or
exceeded, we will deem those provider entities as having met the
requirements. (We note that section 125 of MIPPA redesignated
subsections (b) and (e) of subsection 1865 of the Act as (a) and (d),
respectively.) 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). The regulations at Sec. 488.8(d)(3) require
accrediting organizations to reapply for continued deeming authority
every 6 years or as we determine.
Section 125 of MIPPA revoked the Joint Commission's statutory
deeming status for their hospital program and required the Joint
Commission to apply to be recognized as a national accreditation body
for hospitals, based on terms and conditions required by the Secretary.
These terms and conditions are outlined under part 488, subpart A, as
described above. Based on the 24-month transition period allowed by
section 125 of MIPPA, the Joint Commission's term of approval as a
recognized accreditation program for hospitals expires July 15, 2010.
II. Approval of Deeming Organizations
Section 1865(a)(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 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(a)(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 a notice of approval or denial of the
application.
The purpose of this proposed notice is to inform the public of the
Joint
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Commission's request for continued deeming authority for hospitals.
This notice also solicits public comment on whether the Joint
Commission's requirements meet or exceed the Medicare conditions for
participation for hospitals.
III. Evaluation of Deeming Authority Request
The Joint Commission submitted all the necessary materials to
enable us to make a determination concerning its request for reapproval
as a deeming organization for hospitals. This application was
determined to be complete on May 1, 2009. Under section 1865(a)(2) of
the Act and our regulations at Sec. 488.8 (Federal review of
accrediting organizations), our review and evaluation of the Joint
Commission will be conducted in accordance with, but not necessarily
limited to, the following factors:
The equivalency of the Joint Commission's standards for a
hospital as compared with CMS' hospital conditions of participation.
The Joint Commission'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 the Joint Commission's processes to those of
State agencies, including survey frequency, and the ability to
investigate and respond appropriately to complaints against accredited
facilities.
--The Joint Commission's processes and procedures for monitoring
hospitals found out of compliance with the Joint Commission's program
requirements. These monitoring procedures are used only when the Joint
Commission identifies noncompliance. If noncompliance is identified
through validation reviews, the State survey agency monitors
corrections as specified at Sec. 488.7(d).
--The Joint Commission's capacity to report deficiencies to the
surveyed facilities and respond to the facility's plan of correction in
a timely manner.
--The Joint Commission'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 the Joint Commission's staff and other resources, and
its financial viability.
--The Joint Commission's capacity to adequately fund required surveys.
--The Joint Commission's policies with respect to whether surveys are
announced or unannounced, to assure that surveys are unannounced.
--The Joint Commission'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).
(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: May 14, 2009.
Charlene Frizzera,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E9-15183 Filed 6-25-09; 8:45 am]
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