[Federal Register Volume 76, Number 93 (Friday, May 13, 2011)]
[Notices]
[Pages 28040-28042]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-11705]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services
[CMS-2375-PN]
Medicare and Medicaid Programs; Application by the Joint
Commission for Continued Deeming Authority for Critical Access
Hospitals
AGENCY: Centers for Medicare and Medicaid Services (CMS), HHS.
ACTION: Proposed Notice.
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SUMMARY: This proposed notice with comment period acknowledges the
receipt of an application from the Joint Commission for continued
recognition as a national accrediting organization for critical access
hospitals (CAHs) that wish to participate in the Medicare or Medicaid
programs. Section 1865(a)(3)(A) of the Social Security 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. on June 13, 2011.
ADDRESSES: In commenting, please refer to file code CMS-2375-PN.
Because of staff and resource limitations, we cannot accept comments by
facsimile (FAX) transmission.
You may submit comments in one of four ways (no duplicates,
please):
1. Electronically. You may submit electronic comments on specific
issues in this regulation to http://www.cms.hhs.gov/eRulemaking. Click
on the link ``Submit electronic comments on CMS regulations with an
open comment period.'' (Attachments should be in Microsoft Word,
WordPerfect, or Excel; however, we prefer Microsoft Word.)
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-2375-PN, P.O. Box 8016, Baltimore, MD
21244-8016.
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-2375-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 one of the following addresses. 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.
Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue,
SW., Washington, DC 20201; or 7500 Security Boulevard, Baltimore, MD
21244-1850.
(Because access to the interior of the 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.)
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: L. Tyler Whitaker, (410) 786-5236.
Patricia Chmielewski, (410) 786-6899.
SUPPLEMENTARY INFORMATION:
Submitting Comments: We welcome comments from the public on all
issues set forth in this proposed notice to assist us in fully
considering issues and developing policies. You can assist us by
referencing the file code CMS-2375-PN and the specific ``issue
identifier'' that precedes the section on which you choose to comment.
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.cms.hhs.gov/eRulemaking. Click on the link ``Electronic Comments on
CMS Regulations'' on that Web site to view public comments.
Comments received timely will also be available for public
inspection as
[[Page 28041]]
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 in a critical access hospital (CAH) provided certain
requirements are met. Sections 1820(c)(2)(B) and 1861(mm) of the Social
Security Act (the Act) establish distinct criteria for facilities
seeking designation as a CAH. 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 485, subpart F specify the
conditions that a CAH must meet in order to participate in the Medicare
program, and the scope of covered services. The conditions for Medicare
payment for CAHs are set forth at Sec. 413.70.
Generally, in order to enter into a provider agreement with the
Medicare program, a CAH must first be certified by a State survey
agency as complying with the conditions or requirements set forth in
part 485, subpart F. Thereafter, the CAH 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 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 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. The 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 six years or sooner as determined by us.
The Joint Commission's term of approval as a recognized
accreditation program for CAHs expires November 21, 2011.
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 notice of approval or denial of the application.
The purpose of this proposed notice is to inform the public of the
Joint Commission's request for continued deeming authority for CAHs.
This notice also solicits public comment on whether the Joint
Commission's requirements meet or exceed the Medicare conditions for
participation for CAHs.
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 CAHs. This application was determined to
be complete April 1, 2011. 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
CAH as compared with CMS' CAH 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
CAHs 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.
[[Page 28042]]
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).
VI. Regulatory Impact Statement
In accordance with the provisions of Executive Order 12866, 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 Program; No. 93.773 Medicare--Hospital Insurance Program;
and No. 93.774, Medicare--Supplementary Medical Insurance Program)
Dated: May 4, 2011.
Donald M. Berwick,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2011-11705 Filed 5-12-11; 8:45 am]
BILLING CODE 4120-01-P