82 FR 23004 - Medicare and Medicaid Programs: Application From the Joint Commission for Continued CMS-Approval of Its Critical Access Hospital Accreditation Program

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services

Federal Register Volume 82, Issue 96 (May 19, 2017)

Page Range		23004-23005
FR Document		2017-10216

This proposed notice acknowledges the receipt of an application from the Joint Commission for continued recognition as a national accrediting organization for critical access hospitals that wish to participate in the Medicare or Medicaid programs.

Federal Register, Volume 82 Issue 96 (Friday, May 19, 2017)

[Federal Register Volume 82, Number 96 (Friday, May 19, 2017)]
[Notices]
[Pages 23004-23005]
From the Federal Register Online [www.thefederalregister.org]
[FR Doc No: 2017-10216]

[[Page 23004]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-3336-PN]

Medicare and Medicaid Programs: Application From the Joint
Commission for Continued CMS-Approval of Its Critical Access Hospital
Accreditation Program

AGENCY: Centers for Medicare and 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 Joint Commission for continued recognition as a
national accrediting organization for critical access hospitals that
wish to participate in the Medicare or Medicaid programs.

DATES: To be assured consideration, comments must be received at one of
the addresses provided below, no later than 5 p.m. on June 19, 2017.

ADDRESSES: In commenting, please refer to file code CMS-3336-PN.
Because of staff and resource limitations, we cannot accept comments by
facsimile (FAX) transmission.
You may submit comments in one of four 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-3336-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-3336-PN, Mail
Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.
4. By hand or courier. Alternatively, you may deliver (by hand or
courier) your written comments ONLY to the following addresses:
a. For delivery in Washington, DC--Centers for Medicare & Medicaid
Services, Department of Health and Human Services, Room 445-G, Hubert
H. Humphrey Building, 200 Independence Avenue SW., Washington, DC
20201.
(Because access to the interior of the Hubert H. Humphrey 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.)
b. For delivery in Baltimore, MD--Centers for Medicare & Medicaid
Services, Department of Health and Human Services, 7500 Security
Boulevard, Baltimore, MD 21244-1850.
If you intend to deliver your comments to the Baltimore address,
call telephone number (410) 786-9994 in advance to schedule your
arrival with one of our staff members.
Comments erroneously 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: Monda Shaver, (410) 786-3410, Karena
Meushaw, (410) 786-6609, or Patricia Chmielewski, (410) 786-6899.

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 Web
site as soon as possible after they have been received: http://www.regulations.gov. Follow the search instructions on that Web site to
view public comments.
Comments received timely will also be available for public
inspection as 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 by the CAH. Section 1861(mm) of the Social
Security Act (the Act), establishes 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 to participate in the Medicare program,
the scope of covered services, and the conditions for Medicare payment
for CAHs.
Generally, to enter into an agreement, a CAH must first be
certified by a State survey agency as complying with the conditions or
requirements set forth in part 485 of our regulations. 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 that provider entity as having met the
requirements. Accreditation from an accrediting organization is
voluntary and is not required for Medicare participation.
If an accrediting organization 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 accrediting organization applying for approval of its
accreditation program under part 488, subpart A, must provide CMS 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. Our regulations concerning the
approval of accrediting organizations are set forth at Sec. 488.5. The
regulations at Sec. 488.5(e)(2)(i) require an accrediting organization
to reapply for continued approval of its accreditation program every 6
years or sooner, as determined by CMS. The Joint Commission's (TJC's)
current term of approval for its CAH accreditation program expires
November 21, 2017.

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
accrediting

[[Page 23005]]

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 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
TJC's request for continued CMS-approval of its CAH accreditation
program. This notice also solicits public comment on whether TJC's
requirements meet or exceed the Medicare conditions of participation
for CAHs.

III. Evaluation of Deeming Authority Request

TJC submitted all the necessary materials to enable us to make a
determination concerning its request for continued approval of its CAH
accreditation program. This application was determined to be complete
on March 31, 2017. Under Section 1865(a)(2) of the Act and our
regulations at 42 CFR 488.5 (Application and re-application procedures
for national accrediting organizations), our review and evaluation of
TJC will be conducted in accordance with, but not necessarily limited
to, the following factors:
The equivalency of TJC's standards for CAHs as compared
with CMS' CAH conditions of participation.
TJC'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 TJC's processes to those of State agencies,
including survey frequency, and the ability to investigate and respond
appropriately to complaints against accredited facilities.
++ TJC's processes and procedures for monitoring a CAH is out of
compliance with TJC's program requirements. These monitoring procedures
are used only when TJC identifies noncompliance. If noncompliance is
identified through validation reviews or complaint surveys, the State
survey agency monitors corrections as specified at Sec. 488.9(c).
++ TJC's capacity to report deficiencies to the surveyed facilities
and respond to the facility's plan of correction in a timely manner.
++ TJC'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 TJC's staff and other resources, and its
financial viability.
++ TJC's capacity to adequately fund required surveys.
++ TJC's policies with respect to whether surveys are announced or
unannounced, to assure that surveys are unannounced.
++ TJC's agreement to provide CMS with a copy of the most current
accreditation survey together with any other information related to the
survey as CMS 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 Public 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.
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.

Dated: April 25, 2017.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2017-10216 Filed 5-18-17; 8:45 am]
BILLING CODE 4120-01-P

Federal Register / Vol. 82, No. 96 / Friday, May 19, 2017 / Notices 23005

organization’s requirements consider, noncompliance is identified through DEPARTMENT OF HEALTH AND
among other factors, the applying validation reviews or complaint HUMAN SERVICES
accrediting organization’s requirements surveys, the State survey agency
for accreditation; survey procedures; monitors corrections as specified at Centers for Medicare & Medicaid
resources for conducting required § 488.9(c). Services
surveys; capacity to furnish information ++ TJC’s capacity to report [Document Identifiers: CMS–10175, CMS–
for use in enforcement activities; deficiencies to the surveyed facilities 10220, CMS–10471 and CMS–10495]
monitoring procedures for provider and respond to the facility’s plan of
entities found not in compliance with correction in a timely manner. Agency Information Collection
the conditions or requirements; and ++ TJC’s capacity to provide CMS Activities: Submission for OMB
ability to provide CMS with the with electronic data and reports Review; Comment Request
necessary data for validation. necessary for effective validation and
Section 1865(a)(3)(A) of the Act AGENCY: Centers for Medicare &
assessment of the organization’s survey Medicaid Services, HHS.
further requires that we publish, within
process.
60 days of receipt of an organization’s ACTION: Notice.
complete application, a notice ++ The adequacy of TJC’s staff and
identifying the national accrediting other resources, and its financial SUMMARY: The Centers for Medicare &
body making the request, describing the viability. Medicaid Services (CMS) is announcing
nature of the request, and providing at ++ TJC’s capacity to adequately fund an opportunity for the public to
least a 30-day public comment period. required surveys. comment on CMS’ intention to collect
We have 210 days from the receipt of a ++ TJC’s policies with respect to information from the public. Under the
complete application to publish notice whether surveys are announced or Paperwork Reduction Act of 1995
of approval or denial of the application. unannounced, to assure that surveys are (PRA), federal agencies are required to
The purpose of this proposed notice unannounced. publish notice in the Federal Register
is to inform the public of TJC’s request concerning each proposed collection of
++ TJC’s agreement to provide CMS information, including each proposed
for continued CMS-approval of its CAH with a copy of the most current
accreditation program. This notice also extension or reinstatement of an existing
accreditation survey together with any collection of information, and to allow
solicits public comment on whether other information related to the survey
TJC’s requirements meet or exceed the a second opportunity for public
as CMS may require (including comment on the notice. Interested
Medicare conditions of participation for corrective action plans).
CAHs. persons are invited to send comments
IV. Collection of Information regarding the burden estimate or any
III. Evaluation of Deeming Authority Requirements other aspect of this collection of
Request information, including the necessity and
TJC submitted all the necessary This document does not impose utility of the proposed information
materials to enable us to make a information collection requirements, collection for the proper performance of
determination concerning its request for that is, reporting, recordkeeping or the agency’s functions, the accuracy of
continued approval of its CAH third-party disclosure requirements. the estimated burden, ways to enhance
accreditation program. This application Consequently, there is no need for the quality, utility, and clarity of the
was determined to be complete on review by the Office of Management and information to be collected; and the use
March 31, 2017. Under Section Budget under the authority of the of automated collection techniques or
1865(a)(2) of the Act and our regulations Paperwork Reduction Act of 1995 (44 other forms of information technology to
at 42 CFR 488.5 (Application and re- U.S.C. 3501 et seq.). minimize the information collection
application procedures for national V. Response to Public Comments burden.
accrediting organizations), our review DATES: Comments on the collection(s) of
and evaluation of TJC will be conducted Because of the large number of public
comments we normally receive on information must be received by the
in accordance with, but not necessarily OMB desk officer by June 19, 2017.
limited to, the following factors: Federal Register documents, we are not
• The equivalency of TJC’s standards able to acknowledge or respond to them ADDRESSES: When commenting on the
for CAHs as compared with CMS’ CAH individually. We will consider all proposed information collections,
conditions of participation. comments we receive by the date and please reference the document identifier
• TJC’s survey process to determine time specified in the ‘‘DATES’’ section or OMB control number. To be assured
the following: of this preamble, and, when we proceed consideration, comments and
++ The composition of the survey with a subsequent document, we will recommendations must be received by
team, surveyor qualifications, and the respond to the comments in the the OMB desk officer via one of the
ability of the organization to provide preamble to that document. following transmissions: OMB, Office of
continuing surveyor training. Upon completion of our evaluation, Information and Regulatory Affairs,
++ The comparability of TJC’s including evaluation of comments Attention: CMS Desk Officer, Fax
processes to those of State agencies, received as a result of this notice, we Number: (202) 395–5806 OR, Email:
including survey frequency, and the will publish a final notice in the Federal OIRA_submission@omb.eop.gov.
ability to investigate and respond To obtain copies of a supporting
asabaliauskas on DSK3SPTVN1PROD with NOTICES

Register announcing the result of our
appropriately to complaints against evaluation. statement and any related forms for the
accredited facilities. proposed collection(s) summarized in
++ TJC’s processes and procedures Dated: April 25, 2017. this notice, you may make your request
for monitoring a CAH is out of Seema Verma, using one of following:
compliance with TJC’s program Administrator, Centers for Medicare & 1. Access CMS’ Web site address at
requirements. These monitoring Medicaid Services. Web site address at https://
procedures are used only when TJC [FR Doc. 2017–10216 Filed 5–18–17; 8:45 am] www.cms.gov/Regulations-and-
identifies noncompliance. If BILLING CODE 4120–01–P Guidance/Legislation/

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Document Created: 2018-11-08 08:47:34
Document Modified: 2018-11-08 08:47:34

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice with request for comment.
Dates		To be assured consideration, comments must be received at one of
Contact		Monda Shaver, (410) 786-3410, Karena Meushaw, (410) 786-6609, or Patricia Chmielewski, (410) 786-6899.
FR Citation		82 FR 23004

82 FR 23004 - Medicare and Medicaid Programs: Application From the Joint Commission for Continued CMS-Approval of Its Critical Access Hospital Accreditation Program

DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Medicare & Medicaid Services

Federal Register Volume 82, Issue 96 (May 19, 2017)

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services