[Federal Register Volume 73, Number 36 (Friday, February 22, 2008)]
[Notices]
[Pages 9811-9812]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-2803]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-3186-FN]


Medicare Program: Approval of Application by the Indian Health 
Service (IHS) for Continued Recognition as a National Accreditation 
Organization That Accredits American Indian and Alaska Native (AI/AN) 
Entities To Furnish Outpatient Diabetes Self-Management Training

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Final notice.

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SUMMARY: This final notice announces the approval of the Indian Health 
Service (IHS) as a national accreditation organization for the purpose 
of determining that entities meet the necessary quality standards to 
furnish outpatient diabetes self-management training services under 
Part B of the Medicare program. Therefore, American Indian and Alaska 
Native diabetes self-management training (DSMT) programs accredited by 
the IHS will receive

[[Page 9812]]

deemed status under the Medicare program for purposes of this benefit.

EFFECTIVE DATE: This approval of IHS as a national accreditation 
organization is effective on February 22, 2008.

FOR FURTHER INFORMATION CONTACT: Eva Fung, (410) 786-7539.

SUPPLEMENTARY INFORMATION:

I. Background

    To participate in the Medicare program, diabetes self-management 
training (DSMT) programs must meet conditions for coverage specified in 
our regulations at 42 CFR part 410, subpart H. One requirement is that 
entities must satisfy required quality standards. An entity seeking 
approval as a DSMT supplier must meet the requirements found at Sec.  
410.144 as determined by an organization that meets the standards found 
at Sec.  410.142. These organizations are referred to as national 
accreditation organizations (NAOs).

II. Review Process

    In evaluating an application from an accrediting organization, we 
consider the following factors under section 1865(b)(2) of the Social 
Security Act (the Act):
     Accreditation requirements.
     Survey procedures.
     Ability to provide adequate resources for conducting 
required surveys and to supply information for use in enforcement 
activities.
     Monitoring procedures.
     Ability to provide us with the necessary data for 
validation.
    After the receipt of a written request to become a NAO or to renew 
status as a NAO, a proposed notice is published in the Federal 
Register, with a 30 day public comment period. After review of the 
NAO's application, we are required to publish a final notice of 
approval or denial no later than 210 days after the date of receipt of 
a complete application package from the organization requesting to 
become a NAO.

III. Analysis of and Responses to Public Comments

    We received a complete application from the IHS on July 11, 2007. 
On September 28, 2007, we published a proposed notice in the Federal 
Register (72 FR 55222-55224) announcing the application from the IHS 
for continued approval as a NAO for accrediting of American Indian (AI) 
and Alaska Native (AN) entities that wish to furnish outpatient DSMT to 
Medicare beneficiaries.
    We note that no public comments were received on our proposed 
notice.

IV. Provisions of the Final Notice

    On March 22, 2002, we approved the IHS as a NAO for a term of 6 
years to accredit AI/AN entities that provide diabetes self-management 
training (67 FR 13345). We recognize that the IHS has a solid record of 
experience in past decades in representing the interest of individuals 
with diabetes. The AI/AN population has one of the highest rates of 
diabetes in the world and the prevalence of diabetes is substantially 
higher than in the general U.S. population. Recognizing the size of the 
AI/AN population affected by diabetes, the Congress, since 1979, has 
funded the IHS-administered National Diabetes Program to promote 
collaborative strategies to combat diabetes, to develop standards-of-
care policies for diabetes, to disseminate comprehensive information 
about diabetes, and to advocate for the AI/AN population. The IHS has 
played a leadership role in the development of diabetic care 
surveillance and data collection in the AI/AN diabetes programs. It 
monitors the quality of the AI/AN diabetes education service through 
its National Diabetes Program, IHS Area Consultants, the IHS Model 
Diabetes Program, the Special Diabetes Grant Programs, and the IHS 
Integrated Diabetes Education and Clinical Standards Recognition 
Program for AI/AN communities. Additionally, the IHS works in 
partnership with the IHS Model Diabetes Programs to tailor educational 
materials, treatment programs, nutrition counseling, and physical 
activities to accommodate cultural, physical, and geographical needs.
    A special Task Force consisting of the American Diabetes 
Association, the American Association of Diabetes Educators, the 
American Dietetic Association, the Veteran's Health Service, the 
National Certification Board for Diabetes Educators, the Centers for 
Disease Control and Prevention, the Department of Veterans Affairs, the 
Diabetes Research and Training Centers, the Indian Health Service, and 
the National Certification Board for Diabetes Educators was convened on 
March 31, 2006 and again on September 19, 2006 as part of the process 
to update the National Standards for Diabetes Self-Management Education 
Programs (NSDSMEP). The revised standards were approved on March 25, 
2007 and were published in the June 2007 issue of Diabetes Care. 
(Volume 30, Number 6.) Prior to revision, the Task Force reviewed the 
standards for their appropriateness, relevancy, scientific basis, 
specificity, and ability to be implemented in multiple settings. The 
current NSDSMEP standards (7th Edition) were effectuated in June 2007 
and reflect the changing approaches in diabetes training and education.
    Our findings indicate that the IHS continues to meet our criteria 
as ``a nonprofit organization with demonstrated experience in 
representing the interests of individuals with diabetes'' to accredit 
entities to furnish training as specified in Sec.  410.142(a) and 
continues to meet all applicable requirements in Sec.  410.140 through 
Sec.  410.146.
    The Iowa Foundation for Medicare Care (IFMC) is under contract 
(GS-35F-5831 H/HHSM 500-2006-0015IG) to CMS to validate the 
DSMT accreditation policies of NAOs including IHS. IFMC surveyed a 
sample of IHS accredited facilities. Based on these reviews, we have 
determined that the IHS deeming authority has been exercised in 
compliance with published requirements and have approved IHS' continued 
recognition as a NAO, effective for 6 years, beginning February 22, 
2008.

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).

    Authority: Sections 1865 of the Social Security Act (42 U.S.C. 
1395bb).

(Catalog of Federal Domestic Program No. 93.773, Medicare-Hospital 
Insurance Program; and No. 93.774, Medicare--Supplementary Medical 
Insurance Program)

    Dated: December 6, 2007.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services.8
[FR Doc. E8-2803 Filed 2-21-08; 8:45 am]
BILLING CODE 4120-01-P