Medicare and Medicaid Programs; Approval of the Community Health Accreditation Program for Continued Deeming Authority for Home Health Agencies, 16688-16690 [E8-5073]
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16688
Federal Register / Vol. 73, No. 61 / Friday, March 28, 2008 / Notices
sroberts on PROD1PC70 with NOTICES
which would require additional time to
track changes reliably in population
levels, or recent changes in exposure
sources indicate that future levels are
likely to increase.’’ Chemicals with long
half-lives in the body or persistence in
the environment may not decline
appreciably within shorter time frames
such as 6 years, and longer periods of
monitoring may be necessary to assess
whether exposure levels are changing.
Revised draft exceptions: (a) The
chemical has an established federal
biomonitoring health threshold (e.g.,
CDC’s level of concern for blood lead
levels in children) or after consultation
with relevant federal agencies, CDC
learns that a federal agency considers
the chemical of sufficient priority to
warrant continued monitoring; or (b) the
chemical has a long half-life (e.g., DDE),
which would require additional time to
track changes reliably in population
levels, or recent changes in exposure
sources indicate that future levels are
likely to increase.
Summary of Revised Draft Criteria
As stated, CDC now publicly
announces the final criteria for
removing chemicals from future releases
of the ‘‘Report.’’ These criteria will
become part of a combined process for
nominating candidate chemicals for
inclusion in or removal from the
‘‘Report.’’ The process will include (a)
nominations from the public of
candidate chemicals to include in or
remove from the ‘‘Report,’’ (b) an
external scoring of nominations in
accordance with the published
nomination and removal criteria, and (c)
assistance from the Board of Scientific
Counselors of CDC’s National Center for
Environmental Health/Agency for Toxic
Substances and Disease Registry in
reviewing plans for including or
removing chemicals and identifying
alternatives for monitoring specific atrisk population subgroups. This
combined process will occur
periodically (e.g., every 6 years). Note
that the criteria for selecting and
removing chemicals apply only to
chemicals published in the ‘‘Report’’—
not to those merely nominated.
The final removal criteria are as
follows: A chemical will be removed
from the ‘‘Report’’ if it meets any one of
the following three criteria and does not
meet either of the exceptions to those
criteria. Accordingly, a chemical will be
removed if (1) a new replacement
chemical (i.e., a metabolite or other
chemical) is more representative of
exposure than the chemical currently
measured; or (2) if after three survey
periods (a period of not less than 6
years), detection rates for all chemicals
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17:57 Mar 27, 2008
Jkt 214001
within a method-related group are less
than 5 percent for all population
subgroups (i.e., two sexes, three race/
ethnicity groups, and the age groups
used in the ‘‘Report’’) or; (3) if after
three survey periods (a period of not
less than 6 years), levels of chemicals
within a method-related group are
unchanged or declining in all the
demographic subgroups documented in
the ‘‘Report.’’ Evidence that chemical
levels are unchanged or declining
would be the absence of a statistically
significant (p < 0.05) positive slope of
mean (or geometric mean) levels of the
chemical over the time period.
For a chemical that meets criterion 1,
the chemical would be removed from
future reports and would be replaced
with the new chemical that better
reflects exposure.
For a chemical that meets criterion 2
or 3, the chemical would be removed
from the ‘‘Report’’ for two future survey
periods (4 years) then measured again in
the following survey period (2 years). If
either criterion 2 or 3 is still satisfied for
this 12-year period (three initial 2-year
survey periods, two intervening 2-year
survey periods, final 2-year survey
period), then the chemical would be
removed from the ‘‘Report’’ and not
reinstated unless the chemical once
again met the criteria for inclusion in
the ‘‘Report.’’
A chemical would continue to be
measured and not be removed from the
‘‘Report’’ if it met either of two
exceptions to the above-cited revised
draft criteria: (a) The chemical has an
established federal biomonitoring health
threshold (e.g., CDC’s level of concern
for blood lead levels in children) or after
consultation with relevant federal
agencies CDC learns that a federal
agency considers the chemical of
sufficient priority to warrant continued
monitoring; or (b) the chemical has a
long half-life (e.g., DDE), which would
require additional time to track changes
reliably in population levels, or recent
changes in exposure sources indicate
that future levels are likely to increase.
FOR FURTHER INFORMATION CONTACT:
Dorothy Sussman, Telephone 770–488–
7950.
SUPPLEMENTARY INFORMATION: CDC
publishes the ‘‘Report’’ under
authorities 42 U.S.C. 241 and 42 U.S.C.
242k. The ‘‘Report’’ provides ongoing
assessment using biomonitoring of the
exposure of the noninstitutionalized,
civilian population to environmental
chemicals. Biomonitoring assesses
human exposure to chemicals by
measuring the chemicals or their
metabolites in human specimens such
as blood or urine. For the ‘‘Report,’’ the
PO 00000
Frm 00068
Fmt 4703
Sfmt 4703
term environmental chemical means a
chemical compound or chemical
element present in air, water, soil, dust,
food, or other environmental medium.
The ‘‘Report’’ provides exposure
information about participants in an
ongoing national survey known as the
National Health and Nutrition
Examination Survey (NHANES). This
survey is conducted by CDC’s National
Center for Health Statistics;
measurements are conducted by CDC’s
National Center for Environmental
Health. The first ‘‘Report,’’ published in
March 2001, gave information about
levels of 27 chemicals found in the U.S.
population; the second ‘‘Report’’ was
published in January 2003, and it
contained exposure information on 116
chemicals, including the 27 chemicals
in the first ‘‘Report.’’ The third ‘‘Report’’
was published in July 2005, and it
contained exposure information on 148
chemicals, including data on the
chemicals published in the second
‘‘Report.’’ Copies of the third ‘‘Report’’
can be obtained in the following ways:
Access https://www.cdc.gov/
exposurereport, send an e-mail to
cdcinfo@cdc.gov, or telephone 1–800–
CDC–INFO.
Dated: March 25, 2008.
Kenneth Rose,
Director, Office of Policy, Planning, and
Evaluation, National Center for
Environmental Health/Agency for Toxic
Substances and Disease Registry.
[FR Doc. E8–6350 Filed 3–27–08; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–2276–FN]
Medicare and Medicaid Programs;
Approval of the Community Health
Accreditation Program for Continued
Deeming Authority for Home Health
Agencies
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final Notice.
AGENCY:
SUMMARY: This final notice announces
our decision to approve the Community
Health Accreditation Program (CHAP)
for recognition as a national
accreditation program for home health
agencies (HHAs) seeking to participate
in the Medicare or Medicaid programs.
DATES: Effective Date: This final notice
is effective March 31, 2008 through
March 31, 2012.
FOR FURTHER INFORMATION CONTACT:
E:\FR\FM\28MRN1.SGM
28MRN1
Federal Register / Vol. 73, No. 61 / Friday, March 28, 2008 / Notices
sroberts on PROD1PC70 with NOTICES
Cindy Melanson, (410) 786–0310.
Patricia Chmielewski (410) 786–6899.
SUPPLEMENTARY INFORMATION:
I. Background
Under the Medicare program, eligible
beneficiaries may receive covered
services in a home health agency (HHA)
provided certain requirements are met.
Sections 1861(o), 1891, 1895 and
1861(m) of the Social Security Act (the
Act) establish distinct criteria for
facilities seeking designation as an
HHA. Under this authority, the
minimum requirements that an HHA
must meet to participate in Medicare are
set forth in regulations at 42 CFR part
484 and 409, which determine the basis
and scope of HHA-covered services, and
the conditions for Medicare payment for
home health care. 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.
Generally, to enter into an 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. Then, the HHA is subject to
regular surveys by a State survey agency
to determine whether it continues to
meet those requirements. However,
there is an alternative to surveys by
State agencies.
Section 1865(b)(1) of the Act provides
that, if a provider entity demonstrates
through accreditation by an approved
national accreditation organization that
all applicable Medicare conditions are
met or exceeded, we may ‘‘deem’’ those
provider entities as having met the
requirements. Accreditation by an
accreditation organization is voluntary
and is not required for Medicare
participation.
If an accreditation organization is
recognized by the Secretary as having
standards for accreditation that meet or
exceed Medicare requirements, a
provider entity accredited by the
national accrediting body’s approved
program may be deemed to meet the
Medicare conditions. A national
accreditation organization applying for
approval of deeming authority under
part 488, subpart A, must provide us
with reasonable assurance that the
accreditation organization requires the
accredited provider entities to meet
requirements that are at least as
stringent as the Medicare conditions.
Our regulations concerning re-approval
of accrediting organizations are set forth
at § 488.4 and § 488.8(d)(3). The
regulations at § 488.8(d)(3) require
accreditation organizations to reapply
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for continued approval of deeming
authority every 6 years, or sooner as we
determine. The Community Health
Accreditation Program’s (CHAP) term of
approval as a recognized accreditation
program for HHAs expires March 31,
2008.
II. Deeming Applications Approval
Process
Section 1865(b)(3)(A) of the Act
provides a statutory timetable to ensure
that our review of deeming applications
is conducted in a timely manner. The
Act provides us with 210 calendar days
after the date of receipt of an application
to complete our survey activities and
application review process. Within 60
days of receiving a completed
application, we must publish a notice in
the Federal Register that identifies the
national accreditation body making the
request, describes the request, and
provides no less than a 30-day public
comment period. At the end of the 210day period, we must publish an
approval or denial of the application.
III. Proposed Notice
On October 26, 2007, we published a
proposed notice (72 FR 60853)
announcing CHAP’s request for reapproval as a deeming organization for
HHAs. In the proposed notice, we
detailed our evaluation criteria. Under
section 1865(b)(2) of the Act and our
regulations at § 488.4 (Application and
reapplication procedures for
accreditation organizations), we
conducted a review of CHAP’s
application in accordance with the
criteria specified by our regulation,
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 accredited facilities;
and (5) survey review and decisionmaking process for accreditation.
• A comparison of CHAP’s HHA
accreditation standards to our current
Medicare HHA conditions for
participation.
• A documentation review of CHAP’s
survey processes to:
++ Determine the composition of the
survey team, surveyor qualifications,
and the ability of CHAP to provide
continuing surveyor training.
++ Compare CHAP’s processes to
those of State survey agencies, including
survey frequency, and the ability to
investigate and respond appropriately to
complaints against accredited facilities.
PO 00000
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Fmt 4703
Sfmt 4703
16689
++ Evaluate CHAP’s procedures for
monitoring providers or suppliers found
to be out of compliance with CHAP
program requirements. The monitoring
procedures are used only when the
CHAP identifies noncompliance. If
noncompliance is identified through
validation reviews, the survey agency
monitors corrections as specified at
§ 488.7(d).
++ Assess CHAP’s ability to report
deficiencies to the surveyed facilities
and respond to the facility’s plan of
correction in a timely manner.
++ Establish CHAP’s ability to
provide us with electronic data in
ASCII-comparable code and reports
necessary for effective validation and
assessment of CHAP’s survey process.
++ Determine the adequacy of staff
and other resources.
++ Review CHAP’s ability to provide
adequate funding for performing
required surveys.
++ Confirm CHAP’s policies with
respect to whether surveys are
announced or 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(b)(3)(A) of the Act, the October 26,
2007 proposed notice (72 FR 60853) also
solicited public comments regarding
whether CHAP’s requirements met or
exceeded the Medicare conditions of
participation for HHAs. We received no
public comments in response to our
proposed notice.
IV. Provisions of the Final Notice
A. Differences Between CHAP’s
Standards and Requirements for
Accreditation and Medicare’s
Conditions and Survey Requirements
We compared the standards contained
in CHAP’s accreditation requirements
for HHAs and its survey process in
CHAP’s Application for Renewal of
Deeming Authority for HHA Facilities
with the Medicare HHA conditions for
participation and our State Operations
Manual. Our review and evaluation of
CHAP’s deeming application, which
were conducted as described in section
III of this final notice, yielded the
following:
• In order to meet the requirements at
§ 484.36(c)(2), CHAP added language to
its standards to address that home
health aide services must be ordered by
the physician in the plan of care.
• In order to ensure compliance with
its own policies and procedures related
to surveyors and meet the requirements
E:\FR\FM\28MRN1.SGM
28MRN1
16690
Federal Register / Vol. 73, No. 61 / Friday, March 28, 2008 / Notices
of § 488.4(a)(4), CHAP developed a
Personnel Audit Tool that will be used
bi-annually.
• CHAP developed policies and
procedures to address potential conflict
of interest issues that may result for
CHAP surveyors who also act as
consultants.
• In order to comply with the
requirements of § 488.4(a)(3)(iv), CHAP
revised its process for notifying facilities
of accreditation-related decisions and
developed a tracking system to ensure
that deficiencies cited are appropriately
addressed.
• CHAP added language to their
Complaint Policies and Procedures to
meet CMS requirements at 42 CFR
488.4(a)(6). This new language provides
increased clarity for the prioritization of
complaints, time frames for
investigative site visits and/or other
required activities.
• CHAP revised its complaint policies
to be consistent with CMS policies
listed in Section 5010 of the State
Operations Manual ‘‘(Management of
Complaints and Incidents’’).
• CHAP updated its list of conditions
surveyed during a standard survey to
include the requirements of § 484.11
and § 484.55.
• In accordance with § 488.9, CMS
will conduct a follow-up corporate site
visit in 1 year, to assess CHAP’s
compliance with its own policies and
procedures.
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, 2008
through March 31, 2012.
V. Collection of Information
Requirements
sroberts on PROD1PC70 with NOTICES
This document does not impose
information collection and
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).
(Catalog of Federal Domestic Assistance
Program No. 93.778, Medical Assistance
Program; No. 93.773 Medicare—Hospital
Insurance Program; and No. 93.774,
Medicare—Supplemental Medical Insurance
Program)
VerDate Aug<31>2005
17:57 Mar 27, 2008
Jkt 214001
Dated: January 25, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare
& Medicaid Services
[FR Doc. E8–5073 Filed 3–27–08; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–2277–FN]
Medicare and Medicaid Programs;
Approval of the Joint Commission for
Continued Deeming Authority for
Home Health Agencies
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final Notice.
AGENCY:
SUMMARY: This final notice announces
our decision to approve The Joint
Commission for recognition as a
national accreditation program for home
health agencies (HHAs) seeking to
participate in the Medicare or Medicaid
programs.
DATES: Effective Date: This final notice
is effective March 31, 2008 through
March 31, 2014.
FOR FURTHER INFORMATION CONTACT:
Cindy Melanson, (410) 786–0310.
Patricia Chmielewski (410) 786–6899.
SUPPLEMENTARY INFORMATION:
I. Background
Under the Medicare program, eligible
beneficiaries may receive covered
services in a home health agency (HHA)
provided certain requirements are met.
Sections 1861(o) , 1891, 1895 and
1861(m) of the Social Security Act (the
Act) establish distinct criteria for
facilities seeking designation as an
HHA. Under this authority, the
minimum requirements that an HHA
must meet to participate in Medicare are
set forth in regulations at 42 CFR part
484 and part 409, which determine the
basis and scope of HHA-covered
services, and the conditions for
Medicare payment for home health care.
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.
Generally, to enter into an 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. Then, the HHA is subject to
regular surveys by a State survey agency
PO 00000
Frm 00070
Fmt 4703
Sfmt 4703
to determine whether it continues to
meet those requirements.
There is an alternative to surveys by
State agencies. Section 1865(b)(1) of the
Act provides that, if a provider entity
demonstrates through accreditation by
an approved national accreditation
organization that all applicable
Medicare conditions are met or
exceeded, we may ‘‘deem’’ those
provider entities as having met the
requirements. Accreditation by an
accreditation organization is voluntary
and is not required for Medicare
participation.
If an accreditation organization is
recognized by 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
accreditation organization applying for
approval of deeming authority under
part 488, subpart A must provide us
with reasonable assurance that the
accreditation organization requires the
accredited provider entities to meet
requirements that are at least as
stringent as the Medicare conditions.
Our regulations concerning re-approval
of accrediting organizations are set forth
at section § 488.4 and § 488.8(d)(3). The
regulations at § 488.8(d)(3) require
accreditation organizations to reapply
for continued approval of deeming
authority every 6 years, or sooner as we
determine. The Joint Commission’s term
of approval as a recognized
accreditation program for HHAs expires
March 31, 2008.
II. Deeming Applications Approval
Process
Section 1865(b)(3)(A) of the Act
provides a statutory timetable to ensure
that our review of deeming applications
is conducted in a timely manner. The
Act provides us with 210 calendar days
after the date of receipt of an application
to complete our survey activities and
application review process. Within 60
days of receiving a completed
application, we must publish a notice in
the Federal Register that identifies the
national accreditation body making the
request, describes the request, and
provides no less than a 30-day public
comment period. At the end of the 210day period, we must publish in the
Federal Register, a final notice of
approval or denial of the application.
III. Provisions of the Proposed Notice
On October 26, 2007, we published in
the Federal Register, a proposed notice
(72 FR 60855) announcing The Joint
Commission’s request for re-approval as
E:\FR\FM\28MRN1.SGM
28MRN1
]]>Agencies
[Federal Register Volume 73, Number 61 (Friday, March 28, 2008)]
[Notices]
[Pages 16688-16690]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-5073]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-2276-FN]
Medicare and Medicaid Programs; Approval of the Community Health
Accreditation Program for Continued Deeming Authority for Home Health
Agencies
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final Notice.
-----------------------------------------------------------------------
SUMMARY: This final notice announces our decision to approve the
Community Health Accreditation Program (CHAP) for recognition as a
national accreditation program for home health agencies (HHAs) seeking
to participate in the Medicare or Medicaid programs.
DATES: Effective Date: This final notice is effective March 31, 2008
through March 31, 2012.
FOR FURTHER INFORMATION CONTACT:
[[Page 16689]]
Cindy Melanson, (410) 786-0310.
Patricia Chmielewski (410) 786-6899.
SUPPLEMENTARY INFORMATION:
I. Background
Under the Medicare program, eligible beneficiaries may receive
covered services in a home health agency (HHA) provided certain
requirements are met. Sections 1861(o), 1891, 1895 and 1861(m) of the
Social Security Act (the Act) establish distinct criteria for
facilities seeking designation as an HHA. Under this authority, the
minimum requirements that an HHA must meet to participate in Medicare
are set forth in regulations at 42 CFR part 484 and 409, which
determine the basis and scope of HHA-covered services, and the
conditions for Medicare payment for home health care. 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.
Generally, to enter into an 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.
Then, the HHA is subject to regular surveys by a State survey agency to
determine whether it continues to meet those requirements. However,
there is an alternative to surveys by State agencies.
Section 1865(b)(1) of the Act provides that, if a provider entity
demonstrates through accreditation by an approved national
accreditation organization that all applicable Medicare conditions are
met or exceeded, we may ``deem'' those provider entities as having met
the requirements. Accreditation by an accreditation organization is
voluntary and is not required for Medicare participation.
If an accreditation organization is recognized by the Secretary as
having standards for accreditation that meet or exceed Medicare
requirements, a provider entity accredited by the national accrediting
body's approved program may be deemed to meet the Medicare conditions.
A national accreditation organization applying for approval of deeming
authority under part 488, subpart A, must provide us with reasonable
assurance that the accreditation organization requires the accredited
provider entities to meet requirements that are at least as stringent
as the Medicare conditions. Our regulations concerning re-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 accreditation
organizations to reapply for continued approval of deeming authority
every 6 years, or sooner as we determine. The Community Health
Accreditation Program's (CHAP) term of approval as a recognized
accreditation program for HHAs expires March 31, 2008.
II. Deeming Applications Approval Process
Section 1865(b)(3)(A) of the Act provides a statutory timetable to
ensure that our review of deeming applications is conducted in a timely
manner. The Act provides us with 210 calendar days after the date of
receipt of an application to complete our survey activities and
application review process. Within 60 days of receiving a completed
application, we must publish a notice in the Federal Register that
identifies the national accreditation 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 an
approval or denial of the application.
III. Proposed Notice
On October 26, 2007, we published a proposed notice (72 FR 60853)
announcing CHAP's request for re-approval as a deeming organization for
HHAs. In the proposed notice, we detailed our evaluation criteria.
Under section 1865(b)(2) of the Act and our regulations at Sec. 488.4
(Application and reapplication procedures for accreditation
organizations), we conducted a review of CHAP's application in
accordance with the criteria specified by our regulation, 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 accredited facilities; 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.
A documentation review of CHAP's survey processes to:
++ Determine the composition of the survey team, surveyor
qualifications, and the ability of CHAP to provide continuing surveyor
training.
++ Compare CHAP's processes to those of State survey agencies,
including survey frequency, and the ability to investigate and respond
appropriately to complaints against accredited facilities.
++ Evaluate CHAP's procedures for monitoring providers or suppliers
found to be out of compliance with CHAP program requirements. The
monitoring procedures are used only when the CHAP identifies
noncompliance. If noncompliance is identified through validation
reviews, the survey agency monitors corrections as specified at Sec.
488.7(d).
++ Assess CHAP's ability to report deficiencies to the surveyed
facilities and respond to the facility's plan of correction in a timely
manner.
++ Establish CHAP's ability to provide us with electronic data in
ASCII-comparable code and reports necessary for effective validation
and assessment of CHAP's survey process.
++ Determine the adequacy of staff and other resources.
++ Review CHAP's ability to provide adequate funding for performing
required surveys.
++ Confirm CHAP's policies with respect to whether surveys are
announced or 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(b)(3)(A) of the Act, the October
26, 2007 proposed notice (72 FR 60853) also solicited public comments
regarding whether CHAP's requirements met or exceeded the Medicare
conditions of participation for HHAs. We received no public comments in
response to our proposed notice.
IV. Provisions of the Final Notice
A. Differences Between CHAP's Standards and Requirements for
Accreditation and Medicare's Conditions and Survey Requirements
We compared the standards contained in CHAP's accreditation
requirements for HHAs and its survey process in CHAP's Application for
Renewal of Deeming Authority for HHA Facilities with the Medicare HHA
conditions for participation and our State Operations Manual. Our
review and evaluation of CHAP's deeming application, which were
conducted as described in section III of this final notice, yielded the
following:
In order to meet the requirements at Sec. 484.36(c)(2),
CHAP added language to its standards to address that home health aide
services must be ordered by the physician in the plan of care.
In order to ensure compliance with its own policies and
procedures related to surveyors and meet the requirements
[[Page 16690]]
of Sec. 488.4(a)(4), CHAP developed a Personnel Audit Tool that will
be used bi-annually.
CHAP developed policies and procedures to address
potential conflict of interest issues that may result for CHAP
surveyors who also act as consultants.
In order to comply with the requirements of Sec.
488.4(a)(3)(iv), CHAP revised its process for notifying facilities of
accreditation-related decisions and developed a tracking system to
ensure that deficiencies cited are appropriately addressed.
CHAP added language to their Complaint Policies and
Procedures to meet CMS requirements at 42 CFR 488.4(a)(6). This new
language provides increased clarity for the prioritization of
complaints, time frames for investigative site visits and/or other
required activities.
CHAP revised its complaint policies to be consistent with
CMS policies listed in Section 5010 of the State Operations Manual
``(Management of Complaints and Incidents'').
CHAP updated its list of conditions surveyed during a
standard survey to include the requirements of Sec. 484.11 and Sec.
484.55.
In accordance with Sec. 488.9, CMS will conduct a follow-
up corporate site visit in 1 year, to assess CHAP's compliance with its
own policies and procedures.
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, 2008 through March 31,
2012.
V. Collection of Information Requirements
This document does not impose information collection and
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).
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program; No. 93.773 Medicare--Hospital Insurance Program;
and No. 93.774, Medicare--Supplemental Medical Insurance Program)
Dated: January 25, 2008.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services
[FR Doc. E8-5073 Filed 3-27-08; 8:45 am]
BILLING CODE 4120-01-P
