83_FR_12826 83 FR 12769 - Medicare and Medicaid Programs; Approval of the Community Health Accreditation Partner for Continued CMS Approval of Its Home Health Agency Program

83 FR 12769 - Medicare and Medicaid Programs; Approval of the Community Health Accreditation Partner for Continued CMS Approval of Its Home Health Agency Program

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

Federal Register Volume 83, Issue 57 (March 23, 2018)

Page Range12769-12770
FR Document2018-05891

This notice announces our decision to approve the Community Health Accreditation Partner (CHAP) for continued recognition as a national accrediting organization for home health agencies (HHAs) that wish to participate in the Medicare or Medicaid programs.

Federal Register, Volume 83 Issue 57 (Friday, March 23, 2018) 
[Federal Register Volume 83, Number 57 (Friday, March 23, 2018)]
[Notices]
[Pages 12769-12770]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-05891]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-3349-FN]


Medicare and Medicaid Programs; Approval of the Community Health 
Accreditation Partner for Continued CMS Approval of Its Home Health 
Agency Program

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

ACTION: Notice.

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SUMMARY: This notice announces our decision to approve the Community 
Health Accreditation Partner (CHAP) for continued recognition as a 
national accrediting organization for home health agencies (HHAs) that 
wish to participate in the Medicare or Medicaid programs.

DATES: This notice is applicable March 31, 2018 through March 31, 2024.

FOR FURTHER INFORMATION CONTACT: Lillian Williams (410) 786-8636, Monda 
Shaver, (410) 786-3410, or Patricia Chmielewski (410) 786-6899.

SUPPLEMENTARY INFORMATION: 

I. Background

    Under the Medicare program, eligible beneficiaries may receive 
covered services from a home health agency (HHA) provided certain 
requirements are met. Sections 1861(m) and (o), 1891, and 1895 of the 
Social Security Act (the Act) establish distinct criteria for entities 
seeking designation as an HHA. Regulations concerning provider 
agreements are at 42 CFR part 489 and those pertaining to activities 
relating to the survey and certification of agencies and other entities 
are at 42 CFR part 488. The regulations at 42 CFR parts 409 and 484 
specify the conditions that an HHA must meet to participate in the 
Medicare program, the scope of covered services and the conditions for 
Medicare payment for home health care.
    Generally, to enter into a provider agreement with the Medicare 
program, an HHA must first be certified by a state survey agency as 
complying with conditions or requirements set forth in part 484 of our 
regulations. Thereafter, the HHA is subject to regular surveys by a 
state survey agency to determine whether it continues to meet these 
requirements.
    However, there is an alternative 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 of 
Health and Human Services as having standards for accreditation that 
meet or exceed Medicare requirements, any provider entity accredited by 
the national accrediting organization's approved program may be deemed 
to meet the Medicare conditions. A national accrediting organization 
applying for CMS approval of their accreditation program under 42 CFR 
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. Section 488.5(e)(2)(i) 
requires accrediting organizations to reapply for continued approval of 
its Medicare accreditation program every 6 years or sooner as 
determined by CMS. The Community Health Accreditation Partner's 
(CHAP'S) term of approval as a recognized accreditation program for 
HHAs expires March 31, 2018.

II. Approval of Accreditation Organizations

    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 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 of receiving 
a completed 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. Proposed Notice

    On October 20, 2017, we published a proposed notice in the Federal 
Register (82 FR 48817) announcing CHAP's request for continued approval 
of its Medicare HHA accreditation program. In the proposed notice, we 
detailed our evaluation criteria. Under section 1865(a)(2) of the Act 
and Sec.  488.5, we

[[Page 12770]]

conducted a review of CHAP's Medicare HHA application in accordance 
with the criteria specified by our regulations, which include, but are 
not limited to the following:
     An onsite administrative review of CHAP's: (1) Corporate 
policies; (2) financial and human resources available to accomplish the 
proposed surveys; (3) procedures for training, monitoring, and 
evaluation of its surveyors; (4) ability to investigate and respond 
appropriately to complaints against HHAs; and (5) survey review and 
decision-making process for accreditation;
     A comparison of CHAP's HHA accreditation standards to our 
current Medicare HHA conditions for participation (CoPs);
     A documentation review of CHAP's survey processes to:
    ++ Determine the composition of the survey team, surveyor 
qualifications, and CHAP's ability to provide continuing surveyor 
training.
    ++ Compare CHAP'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 CHAP's procedures for monitoring HHAs found to be out 
of compliance with CHAP program requirements. This pertains only to 
monitoring procedures when CHAP identifies non-compliance. If non-
compliance is identified by a state survey agency through a validation 
survey, the state survey agency monitors corrections as specified at 
Sec.  488.9(c)[rtarr8]
    ++ Assess CHAP's ability to report deficiencies to the surveyed 
HHAs and respond to the HHA's plan of correction in a timely manner.
    ++ Establish CHAP's ability to provide CMS with electronic data and 
reports necessary for effective validation and assessment of the 
organization's survey process.
    ++ Determine the adequacy of CHAP's staff and other resources.
    ++ Confirm CHAP's ability to provide adequate funding for the 
completion of required surveys.
    ++ Confirm CHAP's policies for surveys being unannounced.
    ++ Obtain CHAP'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 October 
20, 2017 proposed notice (82 FR 48817) also solicited public comments 
regarding whether CHAP's requirements met or exceeded the Medicare CoPs 
for HHAs. There were no comments submitted.

IV. Provisions of the Final Notice

A. Differences Between CHAP's Standards and Requirements for 
Accreditation and Medicare Conditions of Participation and Survey 
Requirements

    We compared CHAP's accreditation requirements for HHAs and its 
survey process with the Medicare CoPs at 42 CFR part 484, and the 
survey and certification process requirements of 42 CFR parts 488 and 
489. CHAP's standards crosswalk, which crosswalks CHAP standards to the 
corresponding Medicare requirements and regulations, was also examined 
to ensure that the appropriate CMS regulation would be included in 
citations as appropriate. Our review and evaluation of CHAP'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, CHAP has revised its survey processes so that its processes are 
comparable to CMS requirements:
     Sec.  488.5(a)(4)(vii), to ensure plans of corrections 
(PoCs) address all non-compliant practices and include policy changes 
required to correct the deficient practice.
     Sec.  488.5(a)(7) through (9), to ensure surveyors 
maintain current licensure, that new surveyors receive the minimum 
number of mentored surveys prior to surveying independently, and that 
all new surveyors receive a 90-day evaluation of performance.
     Sec.  488.5(a)(12), to ensure the appropriate number of 
medical records are reviewed during complaint investigations.
     Sec.  488.26(b), to ensure that survey documentation 
includes a detailed deficiency statement that clearly outlines the 
number of medical records reviewed, describes the manner and degree of 
non-compliance, and supports the appropriate level of deficiency 
citation.

B. Term of Approval

    Based on the review and observations described in section III. of 
this final notice, we have determined that CHAP's requirements for HHAs 
meet or exceed our requirements. Therefore, we approve CHAP as a 
national accreditation organization for HHAs that request participation 
in the Medicare program, effective March 31, 2018 through March 31, 
2024.

V. Collection of Information Requirements

    This document does not impose information collection requirements, 
that is, reporting, record keeping 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. 35).

    Dated: March 8, 2018.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2018-05891 Filed 3-22-18; 8:45 am]
 BILLING CODE 4120-01-P

Federal Register / Vol. 83, No. 57 / Friday, March 23, 2018 / Notices 12769 police departments, sheriff’s the study over three years, with a study than 63 minutes (total) to complete. departments, or similar governmental goal of obtaining complete Participation is voluntary and there are organizations throughout the anthropometric assessment of 1,000 no costs to the respondents other than continental United States. One thousand LEOs. Information collection for each their time. The total estimated five LEO volunteers will participate in respondent is expected to take no longer annualized burden hours are 353. ESTIMATED ANNUALIZED BURDEN HOURS Average Number of Type of Number of burden per Form name responses per respondents respondents response respondent (in hours) Law Enforcement Officers .............................. Biographical Information ................................ 335 1 3/60 Law Enforcement Officers .............................. Data Sheet ..................................................... 335 1 25/60 Law Enforcement Officers .............................. Assessment of Challenges in Vehicle and 335 1 5/60 with Body Armor. Law Enforcement Officers .............................. Two-dimensional Hand Scan and Three-di- 335 1 30/60 mensional Body Scans. Leroy Richardson, Act) establish distinct criteria for with reasonable assurance that the Chief, Information Collection Review Office, entities seeking designation as an HHA. accrediting organization requires the Office of Scientific Integrity, Office of the Regulations concerning provider accredited provider entities to meet Associate Director for Science, Office of the agreements are at 42 CFR part 489 and requirements that are at least as Director, Centers for Disease Control and those pertaining to activities relating to stringent as the Medicare conditions. Prevention. the survey and certification of agencies Our regulations concerning the approval [FR Doc. 2018–05911 Filed 3–22–18; 8:45 am] and other entities are at 42 CFR part of accrediting organizations are set forth BILLING CODE 4163–18–P 488. The regulations at 42 CFR parts 409 at § 488.5. Section 488.5(e)(2)(i) requires and 484 specify the conditions that an accrediting organizations to reapply for HHA must meet to participate in the continued approval of its Medicare DEPARTMENT OF HEALTH AND Medicare program, the scope of covered accreditation program every 6 years or HUMAN SERVICES services and the conditions for Medicare sooner as determined by CMS. The payment for home health care. Community Health Accreditation Centers for Medicare & Medicaid Generally, to enter into a provider Partner’s (CHAP’S) term of approval as Services agreement with the Medicare program, a recognized accreditation program for [CMS–3349–FN] an HHA must first be certified by a state HHAs expires March 31, 2018. survey agency as complying with Medicare and Medicaid Programs; conditions or requirements set forth in II. Approval of Accreditation Approval of the Community Health part 484 of our regulations. Thereafter, Organizations Accreditation Partner for Continued the HHA is subject to regular surveys by Section 1865(a)(3)(A) of the Act CMS Approval of Its Home Health a state survey agency to determine provides a statutory timetable to ensure Agency Program whether it continues to meet these that our review of applications for CMS- requirements. approval of an accreditation program is AGENCY: Centers for Medicare & However, there is an alternative to conducted in a timely manner. The Act Medicaid Services (CMS), HHS. surveys by state agencies. Section provides us 210 days after the date of ACTION: Notice. 1865(a)(1) of the Act provides that, if a receipt of a complete application, with provider entity demonstrates through any documentation necessary to make SUMMARY: This notice announces our accreditation by an approved national the determination, to complete our decision to approve the Community accrediting organization that all survey activities and application Health Accreditation Partner (CHAP) for applicable Medicare conditions are met process. Within 60 days of receiving a continued recognition as a national or exceeded, we will deem those completed application, we must publish accrediting organization for home health provider entities as having met the a notice in the Federal Register that agencies (HHAs) that wish to participate requirements. Accreditation by an identifies the national accrediting body in the Medicare or Medicaid programs. accrediting organization is voluntary making the request, describes the DATES: This notice is applicable March and is not required for Medicare request, and provides no less than a 30- 31, 2018 through March 31, 2024. participation. day public comment period. At the end FOR FURTHER INFORMATION CONTACT: If an accrediting organization is of the 210-day period, we must publish Lillian Williams (410) 786–8636, Monda recognized by the Secretary of Health a notice in the Federal Register Shaver, (410) 786–3410, or Patricia and Human Services as having approving or denying the application. Chmielewski (410) 786–6899. standards for accreditation that meet or SUPPLEMENTARY INFORMATION: exceed Medicare requirements, any III. Proposed Notice provider entity accredited by the On October 20, 2017, we published a I. Background amozie on DSK30RV082PROD with NOTICES national accrediting organization’s proposed notice in the Federal Register Under the Medicare program, eligible approved program may be deemed to (82 FR 48817) announcing CHAP’s beneficiaries may receive covered meet the Medicare conditions. A request for continued approval of its services from a home health agency national accrediting organization Medicare HHA accreditation program. (HHA) provided certain requirements applying for CMS approval of their In the proposed notice, we detailed our are met. Sections 1861(m) and (o), 1891, accreditation program under 42 CFR evaluation criteria. Under section and 1895 of the Social Security Act (the part 488, subpart A, must provide CMS 1865(a)(2) of the Act and § 488.5, we VerDate Sep<11>2014 21:54 Mar 22, 2018 Jkt 244001 PO 00000 Frm 00056 Fmt 4703 Sfmt 4703 E:\FR\FM\23MRN1.SGM 23MRN1

12770 Federal Register / Vol. 83, No. 57 / Friday, March 23, 2018 / Notices conducted a review of CHAP’s Medicare exceeded the Medicare CoPs for HHAs. V. Collection of Information HHA application in accordance with the There were no comments submitted. Requirements criteria specified by our regulations, This document does not impose which include, but are not limited to the IV. Provisions of the Final Notice information collection requirements, following: A. Differences Between CHAP’s that is, reporting, record keeping or • An onsite administrative review of Standards and Requirements for third-party disclosure requirements. CHAP’s: (1) Corporate policies; (2) Accreditation and Medicare Conditions Consequently, there is no need for financial and human resources available of Participation and Survey review by the Office of Management and to accomplish the proposed surveys; (3) Requirements Budget under the authority of the procedures for training, monitoring, and Paperwork Reduction Act of 1995 (44 evaluation of its surveyors; (4) ability to We compared CHAP’s accreditation U.S.C. 35). investigate and respond appropriately to requirements for HHAs and its survey complaints against HHAs; and (5) process with the Medicare CoPs at 42 Dated: March 8, 2018. survey review and decision-making CFR part 484, and the survey and Seema Verma, process for accreditation; certification process requirements of 42 Administrator, Centers for Medicare & • A comparison of CHAP’s HHA CFR parts 488 and 489. CHAP’s Medicaid Services. accreditation standards to our current standards crosswalk, which crosswalks [FR Doc. 2018–05891 Filed 3–22–18; 8:45 am] Medicare HHA conditions for CHAP standards to the corresponding BILLING CODE 4120–01–P participation (CoPs); Medicare requirements and regulations, • A documentation review of CHAP’s was also examined to ensure that the survey processes to: appropriate CMS regulation would be DEPARTMENT OF HEALTH AND ++ Determine the composition of the included in citations as appropriate. HUMAN SERVICES survey team, surveyor qualifications, Our review and evaluation of CHAP’s and CHAP’s ability to provide Centers for Medicare & Medicaid HHA application, which were Services continuing surveyor training. conducted as described in section III. of ++ Compare CHAP’s processes to this final notice, yielded the following [CMS–2397–FN] those we require of state survey areas where, as of the date of this notice, RIN–0938–ZB29 agencies, including periodic resurvey CHAP has revised its survey processes and the ability to investigate and so that its processes are comparable to Medicaid Program; Announcement of respond appropriately to complaints CMS requirements: Medicaid Drug Rebate Program against accredited HHAs. • § 488.5(a)(4)(vii), to ensure plans of National Rebate Agreement ++ Evaluate CHAP’s procedures for corrections (PoCs) address all non- AGENCY: Centers for Medicare & monitoring HHAs found to be out of compliant practices and include policy Medicaid Services (CMS), HHS. compliance with CHAP program changes required to correct the deficient requirements. This pertains only to ACTION: Final notice. monitoring procedures when CHAP practice. identifies non-compliance. If non- • § 488.5(a)(7) through (9), to ensure SUMMARY: This final notice announces compliance is identified by a state surveyors maintain current licensure, changes to the Medicaid National Drug survey agency through a validation that new surveyors receive the Rebate Agreement (NDRA, or survey, the state survey agency monitors minimum number of mentored surveys Agreement) for use by the Secretary of corrections as specified at § 488.9(c)➢ prior to surveying independently, and the Department of Health and Human ++ Assess CHAP’s ability to report that all new surveyors receive a 90-day Services (HHS) and manufacturers deficiencies to the surveyed HHAs and evaluation of performance. under the Medicaid Drug Rebate respond to the HHA’s plan of correction • § 488.5(a)(12), to ensure the Program (MDRP). We are updating the in a timely manner. appropriate number of medical records NDRA to incorporate legislative and ++ Establish CHAP’s ability to are reviewed during complaint regulatory changes that have occurred provide CMS with electronic data and investigations. since the Agreement was published in reports necessary for effective validation the February 21, 1991 Federal Register and assessment of the organization’s • § 488.26(b), to ensure that survey (56 FR 7049). We are also updating the survey process. documentation includes a detailed NDRA to make editorial and structural ++ Determine the adequacy of deficiency statement that clearly revisions, such as references to the CHAP’s staff and other resources. outlines the number of medical records updated Office of Management and ++ Confirm CHAP’s ability to provide reviewed, describes the manner and Budget (OMB)-approved data collection adequate funding for the completion of degree of non-compliance, and supports forms and electronic data reporting. required surveys. the appropriate level of deficiency DATES: ++ Confirm CHAP’s policies for citation. Applicability Date: The updated surveys being unannounced. B. Term of Approval National Medicaid Drug Rebate ++ Obtain CHAP’s agreement to Agreement (NDRA) provided in the provide us with a copy of the most Based on the review and observations Addendum to this final notice will be current accreditation survey together described in section III. of this final applicable on March 23, 2018. with any other information related to notice, we have determined that CHAP’s Compliance Date: Publication of amozie on DSK30RV082PROD with NOTICES the survey as we may require, including requirements for HHAs meet or exceed CMS–2397–FN serves as written notice corrective action plans. our requirements. Therefore, we of good cause to terminate all existing In accordance with section approve CHAP as a national rebate agreements as of the first day of 1865(a)(3)(A) of the Act, the October 20, accreditation organization for HHAs that the full calendar quarter which begins at 2017 proposed notice (82 FR 48817) also request participation in the Medicare least 6 months after the effective date of solicited public comments regarding program, effective March 31, 2018 the updated NDRA (October 1, 2018). whether CHAP’s requirements met or through March 31, 2024. Manufacturers with an existing active VerDate Sep<11>2014 21:54 Mar 22, 2018 Jkt 244001 PO 00000 Frm 00057 Fmt 4703 Sfmt 4703 E:\FR\FM\23MRN1.SGM 23MRN1


Document Created: 2018-11-01 08:54:20
Document Modified: 2018-11-01 08:54:20
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesThis notice is applicable March 31, 2018 through March 31, 2024.
ContactLillian Williams (410) 786-8636, Monda Shaver, (410) 786-3410, or Patricia Chmielewski (410) 786-6899.
FR Citation83 FR 12769 
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