[Federal Register Volume 63, Number 247 (Thursday, December 24, 1998)]
[Notices]
[Pages 71296-71297]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-34063]
[[Page 71296]]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[HCFA-2036-NC]
RIN 0938-AJ25
Medicare and Medicaid Programs; Recognition of the Commission for
Accreditation of Rehabilitation Facilities
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Notice with comment period.
-----------------------------------------------------------------------
SUMMARY: This notice announces and invites comments on the receipt of
an application from the Commission for Accreditation of Rehabilitation
Facilities for recognition as a national accreditation organization
with deemed status authority. The Social Security Act requires us to
publish this notice in which we identify the national accreditation
body making the application, describe the nature of the request, and
provide a 30-day public comment period. The intent of this notice is to
solicit public comment as to the advisability of recognizing the
Commission for Accreditation of Rehabilitation Facilities as a national
accreditation organization with deeming authority to survey and
accredit comprehensive outpatient rehabilitation facilities for
participation in the Medicare or Medicaid programs.
DATES: Comments will be considered if we receive them at the
appropriate address, as provided below, no later than 5 p.m. eastern
time on January 25, 1999.
ADDRESSES: Mail written comments (1 original and 3 copies) to the
following addresses: Health Care Financing Administration, Department
of Health and Human Services, Attention: HCFA-2036-NC, P. O. Box
26688,Baltimore, MD 21207-0488.
If you prefer, you may deliver your written comments (1 original
and 3 copies) to one of the following addresses:
Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW.,
Washington, DC 20201-0001, or
Room C5-16-03, Central Building,7500 Security Boulevard,Baltimore, MD
21244-1850.
Because of staffing and resource limitations, we cannot accept
comments by facsimile (FAX) transmission. In commenting, please refer
to file code HCFA-2036-NC. Written comments received timely will be
available for public inspection as they are received, generally
beginning approximately 3 weeks after publication of a document, in
Room 443-G of the Department's offices at 200 Independence Avenue, SW.,
Washington, DC, on Monday through Friday of each week from 8:30 a.m. to
5 p.m. eastern time (phone: (202) 690-7890).
FOR FURTHER INFORMATION CONTACT: Helaine M. Jeffers, (410) 786-5648.
SUPPLEMENTARY INFORMATION:
I. Background
Providers of health care services participate in the Medicare and
Medicaid programs in accordance with provider agreements with us (for
Medicare) and State Medicaid agencies (for Medicaid). Generally, in
order to enter into a provider agreement, an entity must first be
certified by a State survey agency as complying with the conditions,
requirements or standards set forth in the Social Security Act (the
Act) and regulations. Providers are subject to routine surveys by State
survey agencies to determine whether the provider continues to meet
these requirements.
There is an alternative, however, to surveys by State agencies.
Section 1865 of the Act includes a provision that permits providers of
services to be exempt from routine surveys by State survey agencies to
determine whether they comply with the definition of hospital services
in section 1861(e) of the Act. Specifically, section 1865(b)(1) of the
Act provides that if we find that accreditation of a provider entity by
a national accreditating body demonstrates that all of the applicable
Medicare conditions or requirements are met or exceeded, we would
``deem'' the provider entity as meeting the applicable Medicare
requirements. If a national accrediting organization applies to us for
recognition of its provider accrediting program, we examine its
requirements to determine whether they meet or exceed the Medicare
conditions as we would have applied them. If we were to approve the
accrediting organization as having standards that meet or exceed our
own, providers accredited under the approved program would be
``deemed'' to meet the Medicare conditions of participation or
requirements for which the accreditation standards have been
recognized.
A deemed status provider is one that has voluntarily applied for
and has been accredited by a national accreditation organization under
its approved program that meets or exceeds the applicable Medicare
conditions or requirements. Federal regulations at 42 CFR part 485,
subpart B, set forth the conditions that comprehensive outpatient
rehabilitation facilities (CORFs) must meet to be certified under
section 1861(cc)(2) of the Act and be accepted for participation in the
Medicare program in accordance with 42 CFR part 489.
II. Approval of Accreditation Organization's Program
The purpose of this notice is to notify the public of the receipt
of the Commission for Accreditation of Rehabilitation Facilities'
(CARF) application for approval to participate in the Medicare program
as a national accreditation organization with deemed status authority
for CORF accreditation. This notice also solicits public comment on the
ability of CARF's program requirements to meet or exceed the Medicare
conditions of participation.
Section 1865(b)(2) of the Act sets forth the requirements for us to
make a finding among other factors with respect to a national
accreditation body, as specified in section III. of this notice.
Section 1865(b)(3)(A) of the Act requires that we publish, no later
than 60 days after the date of the receipt of a completed application,
a notice identifying the national accreditation body making the
request, describing the nature of the request, and providing a period
of at least 30 days for the public to comment on the request. In
addition, we have 210 days from the receipt of the request to publish
an approval or denial of the application.
III. Evaluation of the Application
On August 10, 1998, CARF submitted the necessary application
information about its request for our determination that its provider
accreditation program meets or exceeds the Medicare conditions and
certification requirements for CORFs.
Under section 1865(b)(2) of the Act and our regulations at 42 CFR
488.8 (``Federal review of accreditation organizations''), our review
and evaluation of a national accreditation organization will be
conducted in accordance with, but not necessarily limited to, the
following factors:
A determination of the equivalency of an accreditation
organization's requirements for an entity to our requirements for the
entity.
A review of the organization's survey process to determine
the following:
1. The composition of the survey team, surveyor qualifications, and
the ability of the organization to provide continuing surveyor
training.
[[Page 71297]]
2. The organization's comparability of its processes to that of
State agencies, including survey frequency, and the ability to
investigate and respond appropriately to complaints against accredited
facilities.
3. The organization's procedures for monitoring providers or
suppliers found to be out of compliance with program requirements.
These monitoring procedures are used only when it identifies
noncompliance. If noncompliance at the condition level is identified
through validation reviews, the appropriate State survey agency
monitors corrections as specified at Sec. 488.7(b)(2).
4. The organization's ability to report deficiencies to the
surveyed facilities and respond to the facility's plan of correction in
a timely manner.
The organization's ability to provide us with electronic
data in ASCII comparable code and reports necessary for effective
validation and assessment of its survey process.
The adequacy of staff and other resources, and its
financial viability.
The organization's ability to provide adequate funding for
performing required surveys.
The organization's policies with respect to whether
surveys are announced or unannounced.
The organization'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. Notice of Evaluation
Upon completion of our evaluation, including the evaluation of
public comments received as a result of this notice, we will publish a
notice in the Federal Register announcing the result of our evaluation.
V. Response to Public Comments
Because of the large number of comments 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 them in a forthcoming notice
document.
Authority: Section 1865 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: November 30, 1998.
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
[FR Doc. 98-34063 Filed 12-23-98; 8:45 am]
BILLING CODE 4120-01-P