83_FR_52659 83 FR 52458 - Medicare and Medicaid Program; Application from the Accreditation Association for Hospitals/Health Systems-Healthcare Facilities Accreditation Program (AAHHS-HFAP) for Approval of its Hospital Accreditation Program

83 FR 52458 - Medicare and Medicaid Program; Application from the Accreditation Association for Hospitals/Health Systems-Healthcare Facilities Accreditation Program (AAHHS-HFAP) for Approval of its Hospital Accreditation Program

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

Federal Register Volume 83, Issue 201 (October 17, 2018)

Page Range52458-52459
FR Document2018-22546

This proposed notice acknowledges the receipt of an application from the Accreditation Association for Hospitals/Health Systems-Healthcare Facilities Accreditation Program (AAHHS-HFAP) for recognition as a national accrediting organization for hospitals that wish to participate in the Medicare or Medicaid programs.

Federal Register, Volume 83 Issue 201 (Wednesday, October 17, 2018) 
[Federal Register Volume 83, Number 201 (Wednesday, October 17, 2018)]
[Notices]
[Pages 52458-52459]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-22546]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-3370-PN]


Medicare and Medicaid Program; Application from the Accreditation 
Association for Hospitals/Health Systems-Healthcare Facilities 
Accreditation Program (AAHHS-HFAP) for Approval of its Hospital 
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 Association for Hospitals/Health 
Systems-Healthcare Facilities Accreditation Program (AAHHS-HFAP) for 
recognition as a national accrediting organization for 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 November 16, 
2018.

ADDRESSES: In commenting, refer to file code CMS-3370-PN. Because of 
staff and resource limitations, we cannot accept comments by facsimile 
(FAX) transmission.
    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-3370-PN, P.O. Box 8016, 
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-3370-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: Monda Shaver, (410) 786-3410, Mary 
Ellen Palowitch, (410) 786-4496, or Renee Henry, (410) 786-7828.

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: http://www.regulations.gov. Follow the search instructions on that website to 
view public comments.

I. Background

    Under the Medicare program, eligible beneficiaries may receive 
covered services from a hospital, provided that certain requirements 
are met. Section 1861(e) of the Social Security Act (the Act), 
establishes distinct criteria for facilities seeking designation as a 
hospital. 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 482 specify the minimum conditions that a hospital must 
meet to participate in the Medicare program.
    Generally, to enter into an agreement, a hospital must first be 
certified by a state survey agency as complying with the conditions or 
requirements set forth in part 482 of our regulations. Thereafter, the 
hospital 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 may 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 
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 may 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 the 
Centers for Medicare and Medicaid Services (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 accrediting organizations to reapply 
for continued approval of its accreditation program every 6 years or 
sooner as determined by CMS.

II. Provisions of the Proposed Notice

A. Approval of Deeming Organizations

    Section 1865(a)(2) of the Act and our regulations at Sec.  488.5 
require that our

[[Page 52459]]

findings concerning review and approval 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 
AAHHS-HFAP's request for approval of its hospital accreditation 
program. This notice also solicits public comment on whether AAHHS-
HFAP's requirements meet or exceed the Medicare conditions of 
participation (CoPs) for hospitals.

B. Evaluation of Deeming Authority Request

    AAHHS-HFAP submitted all the necessary materials to enable us to 
make a determination concerning its request for continued approval of 
its hospital accreditation program. This application was determined to 
be complete on August 17, 2018. Under section 1865(a)(2) of the Act and 
our regulations at Sec.  488.5 (Application and re-application 
procedures for national accrediting organizations), our review and 
evaluation of AAHHS-HFAP will be conducted in accordance with, but not 
necessarily limited to, the following factors:
     The equivalency of AAHHS-HFAP's standards for hospitals as 
compared with CMS' hospital CoPs.
     AAHHS-HFAP'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 AAHHS-HFAP's processes to those of state 
agencies, including survey frequency, and the ability to investigate 
and respond appropriately to complaints against accredited facilities.
    ++ AAHHS-HFAP's processes and procedures for monitoring a hospital 
found out of compliance with the AAHHS-HFAP's program requirements. 
These monitoring procedures are used only when the AAHHS-HFAP 
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).
    ++ AAHHS-HFAP's capacity to report deficiencies to the surveyed 
facilities and respond to the facility's plan of correction in a timely 
manner.
    ++ AAHHS-HFAP'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 AAHHS-HFAP's staff and other resources, and its 
financial viability.
    ++ AAHHS-HFAP's capacity to adequately fund required surveys.
    ++ AAHHS-HFAP's policies with respect to whether surveys are 
announced or unannounced, to assure that surveys are unannounced.
    ++ AAHHS-HFAP'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).

C. Notice Upon Completion of Evaluation

    Upon completion of our evaluation, including evaluation of public 
comments received as a result of this notice, we will publish a final 
notice in the Federal Register announcing the result of our evaluation.

III. 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. Chapter 35).

IV. 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.

    Dated: October 10, 2018.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2018-22546 Filed 10-16-18; 8:45 am]
 BILLING CODE 4120-01-P

52458 Federal Register / Vol. 83, No. 201 / Wednesday, October 17, 2018 / Notices proposed rule (and subsequent final application from the Accreditation services from a hospital, provided that rule) that imposes substantial direct Association for Hospitals/Health certain requirements are met. Section requirement costs on state and local Systems-Healthcare Facilities 1861(e) of the Social Security Act (the governments, preempts state law, or Accreditation Program (AAHHS–HFAP) Act), establishes distinct criteria for otherwise has Federalism implications. for recognition as a national accrediting facilities seeking designation as a This notice will not have a substantial organization for hospitals that wish to hospital. Regulations concerning direct effect on state or local participate in the Medicare or Medicaid provider agreements are at 42 CFR part governments, preempt state law, or programs. 489 and those pertaining to activities otherwise have Federalism implications. DATES: To be assured consideration, relating to the survey and certification Executive Order 13771, titled comments must be received at one of of facilities are at 42 CFR part 488. The ‘‘Reducing Regulation and Controlling the addresses provided below, no later regulations at 42 CFR part 482 specify Regulatory Costs,’’ was issued on than 5 p.m. on November 16, 2018. the minimum conditions that a hospital January 30, 2017 (82 FR 9339, February ADDRESSES: In commenting, refer to file must meet to participate in the Medicare 3, 2017). It has been determined that code CMS–3370–PN. Because of staff program. this notice is a transfer notice that does and resource limitations, we cannot Generally, to enter into an agreement, not impose more than de minimis costs accept comments by facsimile (FAX) a hospital must first be certified by a and thus is not a regulatory action for transmission. state survey agency as complying with the purposes of E.O. 13771. Comments, including mass comment the conditions or requirements set forth Consistent with the Congressional submissions, must be submitted in one in part 482 of our regulations. Review Act provisions of the Small of the following three ways (please Thereafter, the hospital is subject to Business Regulatory Enforcement choose only one of the ways listed): regular surveys by a state survey agency Fairness Act of 1996 (5 U.S.C. 801 et 1. Electronically. You may submit to determine whether it continues to seq.), this notice has been transmitted to electronic comments on this regulation meet these requirements. There is an the Congress and the Comptroller to http://www.regulations.gov. Follow alternative; however, to surveys by state General for review. the ‘‘Submit a comment’’ instructions. agencies. In accordance with the provisions of 2. By regular mail. You may mail Section 1865(a)(1) of the Act provides Executive Order 12866, this notice was written comments to the following that, if a provider entity demonstrates reviewed by the Office of Management address ONLY: Centers for Medicare & through accreditation by an approved and Budget. Medicaid Services, Department of national accrediting organization that all Although this notice does not Health and Human Services, Attention: applicable Medicare conditions are met constitute a substantive rule, we CMS–3370–PN, P.O. Box 8016, or exceeded, we may deem those nevertheless prepared this Impact Baltimore, MD 21244–8010. provider entities as having met the Analysis in the interest of ensuring that Please allow sufficient time for mailed requirements. Accreditation by an the impacts of this notice are fully comments to be received before the accrediting organization is voluntary understood. close of the comment period. and is not required for Medicare Dated: October 3, 2018. 3. By express or overnight mail. You participation. Seema Verma, may send written comments to the If an accrediting organization is Administrator, Centers for Medicare & following address ONLY: Centers for recognized by the Secretary of the Medicaid Services. Medicare & Medicaid Services, Department of Health and Human Dated: October 11, 2018. Department of Health and Human Services (the Secretary) as having Services, Attention: CMS–3370–PN, standards for accreditation that meet or Alex M. Azar II, Mail Stop C4–26–05, 7500 Security exceed Medicare requirements, any Secretary, Department of Health and Human Boulevard, Baltimore, MD 21244–1850. provider entity accredited by the Services. For information on viewing public national accrediting body’s approved [FR Doc. 2018–22529 Filed 10–12–18; 11:15 am] comments, see the beginning of the program may be deemed to meet the BILLING CODE 4120–01–P SUPPLEMENTARY INFORMATION section. Medicare conditions. A national FOR FURTHER INFORMATION CONTACT: accrediting organization applying for DEPARTMENT OF HEALTH AND Monda Shaver, (410) 786–3410, Mary approval of its accreditation program HUMAN SERVICES Ellen Palowitch, (410) 786–4496, or under part 488, subpart A, must provide Renee Henry, (410) 786–7828. the Centers for Medicare and Medicaid Centers for Medicare & Medicaid SUPPLEMENTARY INFORMATION: Services (CMS) with reasonable Services Inspection of Public Comments: All assurance that the accrediting comments received before the close of organization requires the accredited [CMS–3370–PN] the comment period are available for provider entities to meet requirements Medicare and Medicaid Program; viewing by the public, including any that are at least as stringent as the personally identifiable or confidential Medicare conditions. Our regulations Application from the Accreditation business information that is included in concerning the approval of accrediting Association for Hospitals/Health a comment. We post all comments organizations are set forth at § 488.5. Systems-Healthcare Facilities received before the close of the The regulations at § 488.5(e)(2)(i) Accreditation Program (AAHHS–HFAP) comment period on the following require accrediting organizations to for Approval of its Hospital website as soon as possible after they reapply for continued approval of its Accreditation Program have been received: http:// daltland on DSKBBV9HB2PROD with NOTICES accreditation program every 6 years or AGENCY: Centers for Medicare & www.regulations.gov. Follow the search sooner as determined by CMS. Medicaid Services (CMS), HHS. instructions on that website to view ACTION: Notice with request for public comments. II. Provisions of the Proposed Notice comment. I. Background A. Approval of Deeming Organizations SUMMARY: This proposed notice Under the Medicare program, eligible Section 1865(a)(2) of the Act and our acknowledges the receipt of an beneficiaries may receive covered regulations at § 488.5 require that our VerDate Sep<11>2014 19:46 Oct 16, 2018 Jkt 247001 PO 00000 Frm 00083 Fmt 4703 Sfmt 4703 E:\FR\FM\17OCN1.SGM 17OCN1

Federal Register / Vol. 83, No. 201 / Wednesday, October 17, 2018 / Notices 52459 findings concerning review and AAHHS–HFAP’s program requirements. Dated: October 10, 2018. approval of a national accrediting These monitoring procedures are used Seema Verma, organization’s requirements consider, only when the AAHHS–HFAP identifies Administrator, Centers for Medicare & among other factors, the applying noncompliance. If noncompliance is Medicaid Services. accrediting organization’s requirements identified through validation reviews or [FR Doc. 2018–22546 Filed 10–16–18; 8:45 am] for accreditation; survey procedures; complaint surveys, the state survey BILLING CODE 4120–01–P resources for conducting required agency monitors corrections as specified surveys; capacity to furnish information at § 488.9(c). for use in enforcement activities; ++ AAHHS–HFAP’s capacity to DEPARTMENT OF HEALTH AND monitoring procedures for provider report deficiencies to the surveyed HUMAN SERVICES entities found not in compliance with facilities and respond to the facility’s the conditions or requirements; and plan of correction in a timely manner. Centers for Medicare & Medicaid ability to provide us with the necessary Services data for validation. ++ AAHHS–HFAP’s capacity to provide CMS with electronic data and [CMS–8068–N] Section 1865(a)(3)(A) of the Act further requires that we publish, within reports necessary for effective validation RIN 0938–AT33 60 days of receipt of an organization’s and assessment of the organization’s complete application, a notice survey process. Medicare Program; CY 2019 Inpatient identifying the national accrediting ++ The adequacy of AAHHS–HFAP’s Hospital Deductible and Hospital and body making the request, describing the staff and other resources, and its Extended Care Services Coinsurance nature of the request, and providing at financial viability. Amounts least a 30-day public comment period. ++ AAHHS–HFAP’s capacity to AGENCY: Centers for Medicare & We have 210 days from the receipt of a adequately fund required surveys. Medicaid Services (CMS), HHS. complete application to publish notice ACTION: Notice. ++ AAHHS–HFAP’s policies with of approval or denial of the application. The purpose of this proposed notice respect to whether surveys are SUMMARY: This notice announces the is to inform the public of AAHHS– announced or unannounced, to assure inpatient hospital deductible and the HFAP’s request for approval of its that surveys are unannounced. hospital and extended care services hospital accreditation program. This ++ AAHHS–HFAP’s agreement to coinsurance amounts for services notice also solicits public comment on provide CMS with a copy of the most furnished in calendar year (CY) 2019 whether AAHHS–HFAP’s requirements current accreditation survey together under Medicare’s Hospital Insurance meet or exceed the Medicare conditions with any other information related to Program (Medicare Part A). The of participation (CoPs) for hospitals. the survey as we may require (including Medicare statute specifies the formulae corrective action plans). used to determine these amounts. For B. Evaluation of Deeming Authority Request C. Notice Upon Completion of CY 2019, the inpatient hospital Evaluation deductible will be $1,364. The daily AAHHS–HFAP submitted all the coinsurance amounts for CY 2019 will necessary materials to enable us to make Upon completion of our evaluation, be: $341 for the 61st through 90th day a determination concerning its request including evaluation of public of hospitalization in a benefit period; for continued approval of its hospital comments received as a result of this $682 for lifetime reserve days; and accreditation program. This application notice, we will publish a final notice in $170.50 for the 21st through 100th day was determined to be complete on the Federal Register announcing the of extended care services in a skilled August 17, 2018. Under section result of our evaluation. nursing facility in a benefit period. 1865(a)(2) of the Act and our regulations DATES: Effective Date: This notice is at § 488.5 (Application and re- III. Collection of Information Requirements effective on January 1, 2019. application procedures for national FOR FURTHER INFORMATION CONTACT: accrediting organizations), our review This document does not impose and evaluation of AAHHS–HFAP will Yaminee Thaker, (410) 786–7921 for information collection requirements, general information. Gregory J. Savord, be conducted in accordance with, but that is, reporting, recordkeeping or not necessarily limited to, the following (410) 786–1521 for case-mix analysis. third-party disclosure requirements. SUPPLEMENTARY INFORMATION: factors: Consequently, there is no need for • The equivalency of AAHHS– I. Background review by the Office of Management and HFAP’s standards for hospitals as Budget under the authority of the Section 1813 of the Social Security compared with CMS’ hospital CoPs. • AAHHS–HFAP’s survey process to Paperwork Reduction Act of 1995 (44 Act (the Act) provides for an inpatient determine the following: U.S.C. Chapter 35). hospital deductible to be subtracted ++ The composition of the survey IV. Response to Comments from the amount payable by Medicare team, surveyor qualifications, and the for inpatient hospital services furnished ability of the organization to provide Because of the large number of public to a beneficiary. It also provides for continuing surveyor training. comments we normally receive on certain coinsurance amounts to be ++ The comparability of AAHHS– Federal Register documents, we are not subtracted from the amounts payable by HFAP’s processes to those of state able to acknowledge or respond to them Medicare for inpatient hospital and daltland on DSKBBV9HB2PROD with NOTICES agencies, including survey frequency, individually. We will consider all extended care services. Section and the ability to investigate and comments we receive by the date and 1813(b)(2) of the Act requires the respond appropriately to complaints time specified in the DATES section of Secretary of the Department of Health against accredited facilities. this preamble, and, when we proceed and Human Services (the Secretary) to ++ AAHHS–HFAP’s processes and with a subsequent document, we will determine and publish each year the procedures for monitoring a hospital respond to the comments in the amount of the inpatient hospital found out of compliance with the preamble to that document. deductible and the hospital and VerDate Sep<11>2014 19:46 Oct 16, 2018 Jkt 247001 PO 00000 Frm 00084 Fmt 4703 Sfmt 4703 E:\FR\FM\17OCN1.SGM 17OCN1


Document Created: 2018-10-17 01:48:21
Document Modified: 2018-10-17 01:48:21
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 with request for comment.
DatesTo be assured consideration, comments must be received at one of
ContactMonda Shaver, (410) 786-3410, Mary Ellen Palowitch, (410) 786-4496, or Renee Henry, (410) 786-7828.
FR Citation83 FR 52458 
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