[Federal Register Volume 80, Number 12 (Tuesday, January 20, 2015)]
[Notices]
[Pages 2708-2710]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-00699]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-3303-FN]


Medicare and Medicaid Programs; Continued Approval of the 
Accreditation Commission for Health Care, Inc.; Home Health Agency 
Accreditation Program

AGENCY: Centers for Medicare and Medicaid Services, HHS.

ACTION: Final notice.

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SUMMARY: This final notice announces our decision to approve the 
Accreditation Commission for Health Care, Inc., (ACHC) for continued 
recognition as a national accrediting organization for home health 
agencies (HHAs) that wish to participate in the Medicare or Medicaid 
programs. An HHA that participates in Medicaid must also meet the 
Medicare conditions for participation (CoPs) as required under 42 CFR 
488.6(b).

DATES: This final notice is effective February 24, 2015 through 
February 24, 2021.

FOR FURTHER INFORMATION CONTACT: Cindy Melanson, (410) 786-0310, or 
Patricia Chmielewski, (410) 786-6899.

SUPPLEMENTARY INFORMATION:

I. Background

    A healthcare provider may enter into an agreement with Medicare to 
participate in the program as a HHA provided certain requirements are 
met. Sections 1861(o) and 1891 of the Social Security Act (the Act), 
establish distinct criteria for facilities seeking designation as a 
HHA. Regulations concerning Medicare provider agreements in general are 
at 42 CFR part 489 and those pertaining to the survey and certification 
for Medicare participation of providers and certain types of suppliers 
are at part 488. The regulations at part 484 specify the specific 
conditions that a provider must meet to participate in the Medicare 
program as an HHA.
    Generally, to enter into a Medicare provider agreement, a facility 
must first be certified as complying with the conditions set forth in 
part 484 and recommended to us for participation by

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a state survey agency. Thereafter, the HHA is subject to periodic 
surveys by a state survey agency to determine whether it continues to 
meet these conditions. However, there is an alternative to 
certification surveys by state agencies. Accreditation by a nationally 
recognized Medicare accreditation program approved by us may substitute 
for both initial and ongoing state review.
    Section 1865(a)(1) of the Act provides that, if the Secretary of 
the Department of Health and Human Services, (the Secretary) finds that 
accreditation of a provider entity by an approved national accrediting 
organization meets or exceeds all applicable Medicare conditions, we 
may treat the provider entity as having met those conditions, that is, 
we may ``deem'' the provider entity to be in compliance. Accreditation 
by an accrediting organization is voluntary and is not required for 
Medicare participation.
    Part 488, subpart A, implements the provisions of section 1865 and 
requires that a national accrediting organization applying for approval 
of its Medicare accreditation program must provide us with reasonable 
assurance that the accrediting organization requires its accredited 
provider entities to meet requirements that are at least as stringent 
as the Medicare conditions. Our regulations concerning the approval 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 an 
accrediting organization to reapply for continued approval of its 
Medicare accreditation program every 6 years or sooner as determined by 
us. ACHC's current term of approval as a recognized Medicare 
accreditation program for HHAs expires February 24, 2015.

II. Application Approval Process

    Section 1865(a)(3)(A) of the Act provides a statutory timetable to 
ensure that our review of applications for CMS-approval of an 
accreditation program is conducted in a timely manner. The Act provides 
us with 210 days after the date of receipt of a complete application, 
with any documentation necessary to make the determination, to complete 
our survey activities and application process. Within 60 days after 
receiving a complete application, we must publish a notice in the 
Federal Register that identifies the national accrediting body making 
the request, describes the request, and provides no less than a 30-day 
public comment period. At the end of the 210-day period, we must 
publish a notice in the Federal Register approving or denying the 
application.

III. Provisions of the Proposed Notice

    In the August 22, 2014 Federal Register (79 FR 49777), we published 
a proposed notice announcing ACHC's request for continued approval of 
its Medicare HHA accreditation program. In that notice, we detailed our 
evaluation criteria. Under section 1865(a)(2) of the Act and in our 
regulations at Sec.  488.4 and Sec.  488.8, we conducted a review of 
ACHC's Medicare HHA accreditation application in accordance with the 
criteria specified by our regulations, which include, but are not 
limited to the following:
     An onsite administrative review of ACHC's: (1) Corporate 
policies; (2) financial and human resources available to accomplish the 
proposed surveys; (3) procedures for training, monitoring, and 
evaluation of its HHA surveyors; (4) ability to investigate and respond 
appropriately to complaints against accredited HHAs; and, (5) survey 
review and decision-making process for accreditation.
     The comparison of ACHC's Medicare accreditation program 
standards to our current Medicare HHA CoPs.
     A documentation review of ACHC's survey process to:
    ++ Determine the composition of the survey team, surveyor 
qualifications, and ACHC's ability to provide continuing surveyor 
training.
    ++ Compare ACHC's processes to those we require of state survey 
agencies, including periodic resurvey and the ability to investigate 
and respond appropriately to complaints against accredited HHAs.
    ++ Evaluate ACHC's procedures for monitoring HHAs it has found to 
be out of compliance with ACHC's program requirements. (This pertains 
only to monitoring procedures when ACHC identifies non-compliance. If 
noncompliance is identified by a state survey agency through a 
validation survey, the state survey agency monitors corrections as 
specified at Sec.  488.7(d).)
    ++ Assess ACHC's ability to report deficiencies to the surveyed HHA 
and respond to the HHA's plan of correction in a timely manner.
    ++ Establish ACHC's ability to provide us with electronic data and 
reports necessary for effective validation and assessment of the 
organization's survey process.
    ++ Determine the adequacy of ACHC's staff and other resources.
    ++ Confirm ACHC's ability to provide adequate funding for 
performing required surveys.
    ++ Confirm ACHC's policies with respect to surveys being 
unannounced.
    ++ Obtain ACHC'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.
    In accordance with section 1865(a)(3)(A) of the Act, the August 22, 
2014 proposed notice also solicited public comments regarding whether 
ACHC's requirements met or exceeded the Medicare CoPs for HHAs. No 
comments were received in response to our proposed notice.

IV. Provisions of the Final Notice

A. Differences Between ACHC's Standards and Requirements for 
Accreditation and Medicare Conditions and Survey Requirements

    We compared ACHC's HHA accreditation requirements and survey 
process with the Medicare CoPs of 42 CFR part 484, and the survey and 
certification process requirements of parts 488 and 489. Our review and 
evaluation of ACHC's HHA application, which were conducted as described 
in section III of this final notice, yielded the following areas where, 
as of the date of this notice, ACHC has completed revising its 
standards and certification processes to meet the requirements at:
     Section 1891(c)(2)(A) of the Act, to ensure all renewal 
surveys are conducted within 36 months of the last survey end date.
     Sec.  484.10(c)(2), to address the patient's right to 
participate in the planning of care.
     Sec.  484.14(e), to ensure personnel records include 
qualifications and current licensure.
     Sec.  488.8(a)(2)(v), to ensure data submitted in CMS' 
Accrediting Organization System for Storing User Recorded Experiences 
(ASSURE) database is complete and accurate.
     Sec.  489.3, to ensure situations that rise to the level 
of immediate jeopardy (IJ) are cited at the condition level.

B. Term of Approval

    Based on our review and observations described in section IV of 
this final notice, we have determined that the ACHC accreditation 
program requirements meet or exceed our requirements. Therefore, we 
approve the ACHC as a national accreditation organization for HHAs that 
request participation in the Medicare program, effective February 24, 
2015 through February 24, 2021.

V. Collection of Information Requirements

    This document does not impose information collection and

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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).

    Dated: January 9, 2015.
Marilyn Tavenner,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2015-00699 Filed 1-16-15; 8:45 am]
BILLING CODE 4120-01-P