Medicare and Medicaid Programs: Application by Accreditation Commission for Health Care for Continued CMS-Approval of Its Hospice Accreditation Program

Citation84 FR 31068
Record Number2019-13901
Published date28 June 2019
SectionNotices
CourtCenters For Medicare And Medicaid Services
Federal Register, Volume 84 Issue 125 (Friday, June 28, 2019)
[Federal Register Volume 84, Number 125 (Friday, June 28, 2019)]
                [Notices]
                [Pages 31068-31070]
                From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
                [FR Doc No: 2019-13901]
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                DEPARTMENT OF HEALTH AND HUMAN SERVICES
                Centers for Medicare and Medicaid Services
                [CMS-3379-PN]
                Medicare and Medicaid Programs: Application by Accreditation
                Commission for Health Care for Continued CMS-Approval of Its Hospice
                Accreditation Program
                AGENCY: Centers for Medicare and Medicaid Services, HHS.
                ACTION: Proposed notice.
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                SUMMARY: This proposed notice acknowledges the receipt of an
                application from the Accreditation Commission for Health Care for
                continued recognition as a national accrediting organization for
                hospices that wish to participate in the Medicare or Medicaid programs.
                The statute requires that within 60 days of receipt of an organizations
                complete application, the Centers for Medicare & Medicaid Services
                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. on July 30, 2019.
                ADDRESSES: In commenting, please refer to file code CMS-3379-PN.
                Because of staff and resource limitations, we cannot accept comments by
                facsimile (FAX) transmission.
                 Comments, including mass comment submissions, must be submitted in
                one of the following three ways (please choose only one of the ways
                listed):
                 1. Electronically. You may submit electronic comments on specific
                issues in this regulation to http://www.regulations.gov. Follow the
                ``submit a comment'' instructions.
                 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-3379-
                [[Page 31069]]
                PN, P.O. Box 8010, Baltimore, MD 21244-8010.
                 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-3379-PN, Mail Stop C4-26-05, 7500
                Security Boulevard, Baltimore, MD 21244-1850.
                FOR FURTHER INFORMATION CONTACT:
                 Lillian Williams, (410) 786-8636.
                 Joy Webb, (410) 786-1667.
                 Karen Tritz, (410) 786-0821.
                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 website as soon as possible after they have been
                received: http://www.regulations.gov. Follow the search instructions on
                that website to view public comments.
                I. Background
                 Under the Medicare program, eligible beneficiaries may receive
                covered services in a hospice provided certain requirements are met by
                the hospice. Sections 1861(dd) of the Social Security Act (the Act)
                establish distinct criteria for facilities seeking designation as a
                hospice. Regulations concerning provider agreements are at 42 CFR part
                489 and those pertaining to activities related to the survey and
                certification of facilities are at 42 CFR part 488. The regulations at
                42 CFR part 418, 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 hospices.
                 Generally, to enter into an agreement, a hospice must first be
                certified by a State survey agency as complying with the conditions or
                requirements set forth in part 418. Thereafter, the hospice is subject
                to regular surveys by a State survey agency to determine whether it
                continues to meet these requirements.
                 However, there is an alternative to surveys by state agencies.
                Section 1865(a)(1) of the Act 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. Accreditation by an accrediting organization is voluntary
                and is not required for Medicare participation.
                 If an accrediting organization is recognized by the Secretary of
                the Department of Health and Human Services 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. 488.5. The regulations at Sec. 488.5(e)(2)(i)
                require accrediting organizations to reapply for continued deeming
                authority every 6 years or sooner as determined by Centers for Medicare
                and Medicaid Services (CMS).
                 The Accreditation Commission for Health Care's (ACHC's) term of
                approval for its hospice accreditation program expires November 27,
                2019.
                II. Approval of Deeming Organizations
                 Section 1865(a)(2) of the Act and our regulations at Sec. 488.5
                require that our findings concerning review and approval 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 CMS 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 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 CMS approval of its hospice accreditation
                program. This notice also solicits public comment on whether ACHC's
                requirements meet or exceed the Medicare conditions for participation
                for hospices.
                III. Evaluation of Deeming Authority Request
                 ACHC submitted all the necessary materials to enable us to make a
                determination concerning its request for continued approval of its
                hospice accreditation program. This application was determined to be
                complete on May 1, 2019. Under Section 1865(a)(2) of the Act and our
                regulations at Sec. 488.5 (Application and re-application procedures
                for national 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 hospices as
                compared with CMS' hospice conditions of participation.
                 ACHC's survey process to determine the following:
                 ++ ACHC's composition of the survey team, surveyor qualifications,
                and the ability of the organization to provide continuing surveyor
                training.
                 ++ ACHC's processes compared 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 a hospice 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, the State
                survey agency monitors corrections as specified at Sec. 488.9(c).
                 ++ 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 CMS with electronic data, and reports
                necessary for effective validation and assessment of the organization's
                survey process.
                 ++ ACHC's staff adequacy 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 CMS 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).
                [[Page 31070]]
                IV. Collection of Information Requirements
                 This document does not impose information collection requirements,
                that is reporting, recordkeeping and third-party disclosure
                requirements. Consequently, there is no need for review by the Office
                of Management and Budget under the authority of the Paperwork Reduction
                Act of 1995 (44 U.S.C. chapter 35).
                V. Response to Comments
                 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.
                 Dated: June 11, 2019.
                Seema Verma,
                Administrator, Centers for Medicare & Medicaid Services.
                [FR Doc. 2019-13901 Filed 6-27-19; 8:45 am]
                BILLING CODE 4120-01-P
                

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