Medicare and Medicaid Programs; Application From the Center for Improvement in Healthcare Quality (CIHQ) for CMS-Approval of Its Hospital Accreditation Program, 12325-12327 [2013-04093]
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Federal Register / Vol. 78, No. 36 / Friday, February 22, 2013 / Notices
have a serious or immediate impact on
patient care.
Register explaining the basis for
removing its approval.
G. Subpart R—Enforcement Procedures
VI. Collection of Information
Requirements
This notice does not impose any
information collection and record
keeping requirements subject to the
Paperwork Reduction Act (PRA).
Consequently, it does not need to be
reviewed by the Office of Management
and Budget (OMB) under the authority
of the PRA. The requirements associated
with the accreditation process for
clinical laboratories under the CLIA
program, codified in 42 CFR part 493
subpart E, are currently approved by
OMB under OMB approval number
0938–0686.
The COLA meets the requirements of
subpart R to the extent that it applies to
accreditation organizations. The COLA
policy sets forth the actions the
organization takes when laboratories it
accredits do not comply with its
requirements and standards for
accreditation. When appropriate, the
COLA will deny, suspend, or revoke
accreditation in a laboratory accredited
by the COLA and report that action to
us within 30 days. The COLA also
provides an appeals process for
laboratories that have had accreditation
denied, suspended, or revoked.
We have determined that the COLA’s
laboratory enforcement and appeal
policies are equal to or more stringent
than the requirements of part 493
subpart R as they apply to accreditation
organizations.
IV. Federal Validation Inspections and
Continuing Oversight
The federal validation inspections of
laboratories accredited by the COLA
may be conducted on a representative
sample basis or in response to
substantial allegations of
noncompliance (that is, complaint
inspections). The outcome of those
validation inspections, performed by
CMS or our agents, or the state survey
agencies, will be our principal means
for verifying that the laboratories
accredited by the COLA remain in
compliance with CLIA requirements.
This federal monitoring is an ongoing
process.
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V. Removal of Approval as an
Accrediting Organization
Our regulations provide that we may
rescind the approval of an accreditation
organization, such as that of the COLA,
for cause, before the end of the effective
date of approval. If we determine that
the COLA has failed to adopt, maintain
and enforce requirements that are equal
to, or more stringent than, the CLIA
requirements, or that systemic problems
exist in its monitoring, inspection or
enforcement processes, we may impose
a probationary period, not to exceed 1
year, in which the COLA would be
allowed to address any identified issues.
Should the COLA be unable to address
the identified issues within that
timeframe, CMS may, in accordance
with the applicable regulations, revoke
COLA’s deeming authority under CLIA.
Should circumstances result in our
withdrawal of the COLA’s approval, we
will publish a notice in the Federal
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16:18 Feb 21, 2013
Jkt 229001
VII. Executive Order 12866 Statement
In accordance with the provisions of
Executive Order 12866, this notice was
not reviewed by the Office of
Management and Budget.
Authority: Section 353 of the Public
Health Service Act (42 U.S.C. 263a).
Dated: February 8, 2013.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. 2013–03927 Filed 2–21–13; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–3280–PN]
Medicare and Medicaid Programs;
Application From the Center for
Improvement in Healthcare Quality
(CIHQ) for CMS-Approval of Its
Hospital Accreditation Program
Centers for Medicare &
Medicaid Services, HHS.
ACTION: Proposed notice.
AGENCY:
This proposed notice with
comment period acknowledges the
receipt of an application from the Center
for Improvement in Healthcare Quality
(CIHQ) 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 March 25, 2013.
ADDRESSES: In commenting, refer to file
code (CMS–3280–PN). Because of staff
and resource limitations, we cannot
accept comments by facsimile (FAX)
transmission.
SUMMARY:
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12325
You may submit comments in one of
four ways (choose only one of the ways
listed):
1. Electronically. You may submit
electronic comments on specific issues
in this regulation to https://
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–3280–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–3280–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 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:
Cindy Melanson, (410) 786–0310.
Patricia Chmielewski, (410) 786–6899.
Monda Shaver, (410) 786–3410.
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Federal Register / Vol. 78, No. 36 / Friday, February 22, 2013 / Notices
SUPPLEMENTARY INFORMATION:
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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: https://
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 hospital provided certain
requirements are met. Section 1861(e) of
the Social Security Act (the Act),
establishes criteria for facilities seeking
designation as a hospital. Regulations
concerning provider agreements are
located at 42 CFR part 489 and those
pertaining to activities relating to the
survey and certification of facilities are
located at 42 CFR part 488. The
regulations at 42 CFR part 482, specify
the conditions that a hospital must meet
to participate in the Medicare programs,
the scope of covered services, and the
conditions for Medicare payment for
hospitals.
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.
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 as having
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16:18 Feb 21, 2013
Jkt 229001
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
us 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 § 488.4 and § 488.8(d)(3). The
regulations at § 488.8(d)(3) require an
accrediting organization to reapply for
continued approval of its accreditation
program every 6 years or sooner as
determined by CMS.
II. Approval of Deeming Organizations
Section 1865(a)(2) of the Act and our
regulations at § 488.8(a) require that our
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 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 that
identifies the national accrediting body
making the request, describes the nature
of the request, and provides at least a
30-day public comment period. We have
210 days from the receipt of a
completed application to publish a
notice of approval or denial of the
application.
The purpose of this proposed notice
is to inform the public of CIHQ’s request
for approval of its hospital accreditation
program. This notice also solicits public
comment on whether CIHQ’s
requirements meet or exceed Medicare’s
conditions of participation for hospitals.
III. Evaluation of Deeming Authority
Request
CIHQ submitted all the necessary
materials to enable us to make a
determination concerning its request for
approval of its hospital accreditation
program. This application was
determined to be complete on January 4,
2013. Under section 1865(a)(2) of the
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Frm 00037
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Sfmt 4703
Act and our regulations at § 488.8
(Federal review of accrediting
organizations), our review and
evaluation of CIHQ will be conducted in
accordance with, but not necessarily
limited to, the following factors:
• The equivalency of CIHQ’s
standards for a hospital as compared
with CMS’ hospital conditions of
participation.
• CIHQ’s survey process to determine
the following:
++ CIHQ’s composition of the survey
team, surveyor qualifications, and the
ability of the organization to provide
continuing surveyor training.
++ CIHQ’s processes compared to
those of State agencies, including survey
frequency, and the ability to investigate
and respond appropriately to
complaints against accredited facilities.
++ CIHQ’s processes and procedures
for monitoring a hospital that is out of
compliance with CIHQ’s program
requirements. These monitoring
procedures are used only when CIHQ
identifies noncompliance. If
noncompliance is identified through
validation reviews or complaint
surveys, the State survey agency
monitors corrections as specified at
§ 488.7(d).
++ CIHQ’s capacity to report
deficiencies to the surveyed facilities
and respond to the facility’s plan of
correction in a timely manner.
++ CIHQ’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 CIHQ’s staff and
other resources, and its financial
viability.
++ CIHQ’s capacity to adequately
fund required surveys.
++ CIHQ’s policies with respect to
whether surveys are announced or
unannounced.
++ CIHQ’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 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.
V. Response to Public Comments
Because of the large number of public
comments we normally receive on
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22FEN1
Federal Register / Vol. 78, No. 36 / Friday, February 22, 2013 / Notices
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.
(Catalog of Federal Domestic Assistance
Program No. 93.778, Medical Assistance
Program; No. 93.773 Medicare—Hospital
Insurance Program; and No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
Dated: February 14, 2013.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. 2013–04093 Filed 2–21–13; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–7027–N]
Medicare, Medicaid, and Children’s
Health Insurance Programs; Meeting of
the Advisory Panel on Outreach and
Education (APOE), March 27, 2013
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice of meeting.
AGENCY:
This notice announces a
meeting of the Advisory Panel on
Outreach and Education (APOE) (the
Panel) in accordance with the Federal
Advisory Committee Act. The Panel
advises and makes recommendations to
the Secretary of Health and Human
Services and the Administrator of the
Centers for Medicare & Medicaid
Services on opportunities to enhance
the effectiveness of consumer education
strategies concerning Medicare,
Medicaid, and the Children’s Health
Insurance Program (CHIP). This meeting
is open to the public.
DATES: Meeting Date: Wednesday,
March 27, 2013, 8:30 a.m. to 4:00 p.m.
Eastern Daylight Time (EDT).
Deadline for Meeting Registration,
Presentations and Comments:
Wednesday, March 13, 2013, 5:00 p.m.,
EDT.
sroberts on DSK5SPTVN1PROD with NOTICES
SUMMARY:
VerDate Mar<15>2010
16:18 Feb 21, 2013
Jkt 229001
Deadline for Requesting Special
Accommodations: Wednesday, March
13, 2013, 5:00 p.m., EDT.
ADDRESSES: Meeting Location: The
Embassy Row Hotel, 2015
Massachusetts Avenue NW.,
Washington, DC 20036.
Presentations and Written Comments:
Jennifer Kordonski, Designated Federal
Official (DFO), Division of Forum and
Conference Development, Office of
Communications, Centers for Medicare
& Medicaid Services, 7500 Security
Boulevard, Mailstop S1–13–05,
Baltimore, MD 21244–1850 or contact
Ms. Kordonski via email at
Jennifer.Kordonski@cms.hhs.gov.
Registration: The meeting is open to
the public, but attendance is limited to
the space available. Persons wishing to
attend this meeting must register at the
Web site https://events.SignUp4.com/
APOEMAR2013MTG or by contacting
the DFO at the address listed in the
ADDRESSES section of this notice or by
telephone at number listed in the FOR
FURTHER INFORMATION CONTACT section of
this notice, by the date listed in the
DATES section of this notice. Individuals
requiring sign language interpretation or
other special accommodations should
contact the DFO at the address listed in
the ADDRESSES section of this notice by
the date listed in the DATES section of
this notice.
FOR FURTHER INFORMATION CONTACT:
Jennifer Kordonski, (410) 786–1840.
Additional information about the APOE
is available on the Internet at https://
www.cms.gov/FACA/04_APOE.asp.
Press inquiries are handled through the
CMS Press Office at (202) 690–6145.
SUPPLEMENTARY INFORMATION: In
accordance with section 10(a) of the
Federal Advisory Committee Act
(FACA), this notice announces a
meeting of the Advisory Panel on
Outreach and Education (APOE) (the
Panel). Section 9(a)(2) of the Federal
Advisory Committee Act authorizes the
Secretary of Health and Human Services
(the Secretary) to establish an advisory
panel if the Secretary determines that
the panel is ‘‘in the public interest in
connection with the performance of
duties imposed * * * by law.’’ Such
duties are imposed by section 1804 of
the Social Security Act (the Act),
requiring the Secretary to provide
informational materials to Medicare
beneficiaries about the Medicare
program, and section 1851(d) of the Act,
requiring the Secretary to provide for
‘‘activities * * * to broadly disseminate
information to [M]edicare beneficiaries
* * * on the coverage options provided
under [Medicare Advantage] in order to
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12327
promote an active, informed selection
among such options.’’
The Panel is also authorized by
section 1114(f) of the Act (42 U.S.C.
1314(f)) and section 222 of the Public
Health Service Act (42 U.S.C. 217a). The
Secretary signed the charter establishing
this Panel on January 21, 1999 (64 FR
7899, February 17, 1999) and approved
the renewal of the charter on January 21,
2011 (76 FR 11782, March 3, 2011).
Pursuant to the amended charter, the
Panel advises and makes
recommendations to the Secretary of
Health and Human Services and the
Administrator of the Centers for
Medicare & Medicaid Services (CMS)
concerning optimal strategies for the
following:
• Developing and implementing
education and outreach programs for
individuals enrolled in, or eligible for,
Medicare, Medicaid, and the Children’s
Health Insurance Program (CHIP).
• Enhancing the federal governments
effectiveness in informing Medicare,
Medicaid, and CHIP consumers,
providers and stakeholders pursuant to
education and outreach programs of
issues regarding these and other health
coverage programs, including the
appropriate use of public-private
partnerships to leverage the resources of
the private sector in educating
beneficiaries, providers and
stakeholders.
• Expanding outreach to vulnerable
and underserved communities,
including racial and ethnic minorities,
in the context of Medicare, Medicaid,
and CHIP education programs.
• Assembling and sharing an
information base of ‘‘best practices’’ for
helping consumers evaluate health plan
options.
• Building and leveraging existing
community infrastructures for
information, counseling, and assistance.
• Drawing the program link between
outreach and education, promoting
consumer understanding of health care
coverage choices and facilitating
consumer selection/enrollment, which
in turn support the overarching goal of
improved access to quality care,
including prevention services,
envisioned under health care reform.
The current members of the Panel are:
Samantha Artiga, Principal Policy
Analyst, Kaiser Family Foundation;
Joseph Baker, President, Medicare
Rights Center; Philip Bergquist,
Manager, Health Center Operations,
CHIPRA Outreach & Enrollment Project
and Director, Michigan Primary Care
Association; Marjorie Cadogan,
Executive Deputy Commissioner,
Department of Social Services; Jonathan
Dauphine, Senior Vice President, AARP;
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22FEN1
]]>Agencies
[Federal Register Volume 78, Number 36 (Friday, February 22, 2013)]
[Notices]
[Pages 12325-12327]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-04093]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-3280-PN]
Medicare and Medicaid Programs; Application From the Center for
Improvement in Healthcare Quality (CIHQ) for CMS-Approval of Its
Hospital Accreditation Program
AGENCY: Centers for Medicare & Medicaid Services, HHS.
ACTION: Proposed notice.
-----------------------------------------------------------------------
SUMMARY: This proposed notice with comment period acknowledges the
receipt of an application from the Center for Improvement in Healthcare
Quality (CIHQ) 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 March 25, 2013.
ADDRESSES: In commenting, refer to file code (CMS-3280-PN). Because of
staff and resource limitations, we cannot accept comments by facsimile
(FAX) transmission.
You may submit comments in one of four ways (choose only one of the
ways listed):
1. Electronically. You may submit electronic comments on specific
issues in this regulation to https://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-3280-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-3280-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 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: Cindy Melanson, (410) 786-0310.
Patricia Chmielewski, (410) 786-6899. Monda Shaver, (410) 786-3410.
[[Page 12326]]
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: https://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 hospital provided certain requirements are met.
Section 1861(e) of the Social Security Act (the Act), establishes
criteria for facilities seeking designation as a hospital. Regulations
concerning provider agreements are located at 42 CFR part 489 and those
pertaining to activities relating to the survey and certification of
facilities are located at 42 CFR part 488. The regulations at 42 CFR
part 482, specify the conditions that a hospital must meet to
participate in the Medicare programs, the scope of covered services,
and the conditions for Medicare payment for hospitals.
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.
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 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 us 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. 488.4 and Sec. 488.8(d)(3). The regulations at Sec. 488.8(d)(3)
require an accrediting organization to reapply for continued approval
of its accreditation program every 6 years or sooner as determined by
CMS.
II. Approval of Deeming Organizations
Section 1865(a)(2) of the Act and our regulations at Sec. 488.8(a)
require that our 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 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 that identifies the national accrediting body making the
request, describes the nature of the request, and provides at least a
30-day public comment period. We have 210 days from the receipt of a
completed application to publish a notice of approval or denial of the
application.
The purpose of this proposed notice is to inform the public of
CIHQ's request for approval of its hospital accreditation program. This
notice also solicits public comment on whether CIHQ's requirements meet
or exceed Medicare's conditions of participation for hospitals.
III. Evaluation of Deeming Authority Request
CIHQ submitted all the necessary materials to enable us to make a
determination concerning its request for approval of its hospital
accreditation program. This application was determined to be complete
on January 4, 2013. Under section 1865(a)(2) of the Act and our
regulations at Sec. 488.8 (Federal review of accrediting
organizations), our review and evaluation of CIHQ will be conducted in
accordance with, but not necessarily limited to, the following factors:
The equivalency of CIHQ's standards for a hospital as
compared with CMS' hospital conditions of participation.
CIHQ's survey process to determine the following:
++ CIHQ's composition of the survey team, surveyor qualifications,
and the ability of the organization to provide continuing surveyor
training.
++ CIHQ's processes compared to those of State agencies, including
survey frequency, and the ability to investigate and respond
appropriately to complaints against accredited facilities.
++ CIHQ's processes and procedures for monitoring a hospital that
is out of compliance with CIHQ's program requirements. These monitoring
procedures are used only when CIHQ identifies noncompliance. If
noncompliance is identified through validation reviews or complaint
surveys, the State survey agency monitors corrections as specified at
Sec. 488.7(d).
++ CIHQ's capacity to report deficiencies to the surveyed
facilities and respond to the facility's plan of correction in a timely
manner.
++ CIHQ'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 CIHQ's staff and other resources, and its
financial viability.
++ CIHQ's capacity to adequately fund required surveys.
++ CIHQ's policies with respect to whether surveys are announced or
unannounced.
++ CIHQ'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 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.
V. Response to Public Comments
Because of the large number of public comments we normally receive
on
[[Page 12327]]
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.
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical
Assistance Program; No. 93.773 Medicare--Hospital Insurance Program;
and No. 93.774, Medicare--Supplementary Medical Insurance Program)
Dated: February 14, 2013.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2013-04093 Filed 2-21-13; 8:45 am]
BILLING CODE 4120-01-P
