[Federal Register Volume 90, Number 120 (Wednesday, June 25, 2025)]
[Notices]
[Pages 27020-27021]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-11701]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-3473-PN]
Medicare and Medicaid Programs: Application From the
Accreditation Commission for Health Care (ACHC) for Continued Approval
of Its Hospice Accreditation Program
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice with request for comment.
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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.
DATES: To be assured consideration, comments must be received at one of
the addresses discussed later in this section, no later than 5 p.m. on
July 25, 2025.
ADDRESSES: In commenting, refer to file code CMS-3473-PN.
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 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-3473-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-3473-PN, Mail
Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.
For information on viewing public comments, see the beginning of
the SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT:
Annette Snyder, (410) 786-0807.
Lillian Williams, (410) 786-8636.
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 at http://www.regulations.gov. Follow the search instructions on that website to
view public comments. CMS will not post on Regulations.gov public
comments that make threats to individuals or institutions or suggest
that the commenter will take actions to harm an individual. CMS
continues to encourage individuals not to submit duplicative comments.
We will post acceptable comments from multiple unique commenters even
if the content is identical or nearly identical to other comments.
I. Background
Under the Medicare program, eligible beneficiaries may receive
covered services from a hospice, provided that certain requirements are
met by the hospice. Section 1861(dd) of the Social Security Act (the
Act) establishes distinct criteria for an agency or organization
seeking designation as a hospice. Regulations concerning provider
agreements are at 42 CFR part 489 and those pertaining to activities
relating to the survey and certification of an agency or organization
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 hospice services.
Generally, to enter into an agreement, a hospice must first be
certified by a state survey agency (SA) as complying with the
conditions or requirements set forth in part 418. Thereafter, the
hospice is subject to regular surveys by an SA agency to determine
whether it continues to meet these requirements.
However, section 1865(a)(1) of the Act provides that, if a provider
entity demonstrates through accreditation by a Centers for Medicare &
Medicaid Services (CMS) approved national Accrediting Organization (AO)
that all applicable Medicare conditions are met or exceeded, we will
deem those provider entities as having met the requirements.
Accreditation by an AO is voluntary and is not required for Medicare
participation.
If an AO is recognized by the Secretary of the Department of Health
and Human Services (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 AO applying
for approval of its accreditation program under part 488, subpart A,
must provide CMS with reasonable assurance that the AO requires the
accredited provider entities to meet requirements that are at least as
stringent as the Medicare conditions. Our regulations concerning the
approval of AOs are set forth at Sec. Sec. 488.4 and 488.5. The
regulations at Sec. 488.5(e)(2)(i) require AOs to reapply for
continued approval of its accreditation program every 6 years or sooner
as determined by CMS. The Accreditation Commission for Health Care's
(ACHC's) current term of approval for their hospice accreditation
program expires November 27, 2025.
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
AO's requirements consider, among other factors, the applying AO'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 approval of its hospice accreditation
program. This notice also solicits public comment on whether the ACHC's
requirements meet or exceed the Medicare conditions of participation
(CoPs) 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, 2025. Under section 1865(a)(2) of the
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Act and our regulations at Sec. 488.5 (Application and re-application
procedures for national accrediting 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 CoPs.
ACHC'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 ACHC's processes 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 hospices which
are 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 or complaint
surveys, the SA monitors corrections as specified at Sec. 488.9.
++ 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.
++ The adequacy of ACHC's staff 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 ensure that surveys are unannounced.
++ ACHC's policies and procedures to avoid conflicts of interest,
including the appearance of conflicts of interest, involving
individuals who conduct surveys or participate in accreditation
decisions.
++ 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).
IV. Collection of Information Requirements
This document does not impose information collection requirements,
that is, reporting, recordkeeping or 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. 3501 et seq.).
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.
The Administrator of the Centers for Medicare & Medicaid Services
(CMS), Mehmet Oz, having reviewed and approved this document,
authorizes Vanessa Garcia to electronically sign this document for
purposes of publication in the Federal Register.
Vanessa Garcia,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2025-11701 Filed 6-24-25; 8:45 am]
BILLING CODE 4120-01-P