Medicare and Medicaid Programs: Application From the Joint Commission for Continued Approval of Its Ambulatory Surgical Center Accreditation Program, 36522-36524 [2014-15101]
Download as PDF
36522
Federal Register / Vol. 79, No. 124 / Friday, June 27, 2014 / Notices
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 as determined
by CMS. Det Norske Veritas Healthcare’s
(DNVHC) current term of approval for
its CAH accreditation program expires
December 23, 2014.
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 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 DNVHC’s
request for continued CMS approval of
its CAH accreditation program. This
notice also solicits public comment on
whether DNVHC’s requirements meet or
exceed the Medicare conditions of
participation (CoPs) for CAHs.
wreier-aviles on DSK5TPTVN1PROD with NOTICES
III. Evaluation of Deeming Authority
Request
DNVHC submitted all the necessary
materials to enable us to make a
determination concerning its request for
continued approval of its CAH
accreditation program. This application
was determined to be complete on May
2, 2014. Under section 1865(a)(2) of the
Act and our regulations at § 488.8
(federal review of accrediting
organizations), our review and
evaluation of DNVHC will be conducted
in accordance with, but not necessarily
limited to, the following factors:
VerDate Mar<15>2010
15:30 Jun 26, 2014
Jkt 232001
• The equivalency of DNVHC’s
standards for CAHs as compared with
CMS’ CAH CoPs.
• DNVHC’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 DNVHC’s
processes to those of state agencies,
including survey frequency, and the
ability to investigate and respond
appropriately to complaints against
accredited facilities.
++ DNVHC’s processes and
procedures for monitoring a CAH found
out of compliance with DNVHC’s
program requirements. These
monitoring procedures are used only
when DNVHC identifies
noncompliance. If noncompliance is
identified through validation reviews or
complaint surveys, the state survey
agency monitors corrections as specified
at § 488.7(d).
++ DNVHC’s capacity to report
deficiencies to the surveyed facilities
and respond to the facility’s plan of
correction in a timely manner.
++ DNVHC’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 DNVHC’s staff
and other resources, and its financial
viability.
++ DNVHC’s capacity to adequately
fund required surveys.
++ DNVHC’s policies with respect to
whether surveys are announced or
unannounced, to assure that surveys are
unannounced.
++ DNVHC’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 (44
U.S.C. 35).
V. Response to Public Comments
Because of the large number of public
comments we normally receive on
Federal Register documents, we are not
able to acknowledge or respond to them
individually. We will consider all
comments we receive by the date and
PO 00000
Frm 00067
Fmt 4703
Sfmt 4703
time specified in the DATES section of
this preamble, and, when we proceed
with a subsequent document, we will
respond to the comments in the
preamble to that document.
Upon completion of our evaluation,
including evaluation of comments
received as a result of this notice, we
will publish a final notice in the Federal
Register announcing the result of our
evaluation.
Dated: June 18, 2014.
Marilyn Tavenner,
Administrator, Centers for Medicare &
Medicaid Services.
[FR Doc. 2014–15100 Filed 6–26–14; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–3297–PN]
Medicare and Medicaid Programs:
Application From the Joint
Commission for Continued Approval of
Its Ambulatory Surgical Center
Accreditation Program
Centers for Medicare and
Medicaid Services, HHS.
ACTION: Proposed notice.
AGENCY:
This proposed notice
acknowledges the receipt of an
application from the Joint Commission
for continued recognition as a national
accrediting organization for ambulatory
surgical centers (ASCs) 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 July 28, 2014.
ADDRESSES: In commenting, please refer
to file code CMS–3297–PN. Because of
staff and resource limitations, we cannot
accept comments by facsimile (FAX)
transmission.
You may submit comments in one of
four ways:
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 (one original and two
copies) to the following address ONLY:
Centers for Medicare & Medicaid
Services, Department of Health and
Human Services, Attention: CMS–3297–
PN, P.O. Box 8016, Baltimore, MD
21244–8010.
SUMMARY:
E:\FR\FM\27JNN1.SGM
27JNN1
wreier-aviles on DSK5TPTVN1PROD with NOTICES
Federal Register / Vol. 79, No. 124 / Friday, June 27, 2014 / Notices
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–3297–PN,
Mail Stop C4–26–05, 7500 Security
Boulevard, Baltimore, MD 21244–1850.
4. By hand or courier. Alternatively,
you may deliver (by hand or courier)
your written comments 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.)
Comments erroneously mailed to the
addresses indicated as appropriate for
hand or courier delivery may be delayed
and received after the comment period.
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.
For information on viewing public
comments, see the beginning of the
SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT:
Monda Shaver, (410) 786–3410. Cindy
Melanson, (410) 786–0310. Patricia
Chmielewski, (410) 786–6899.
SUPPLEMENTARY INFORMATION:
Submitting Comments: We welcome
comments from the public on all issues
set forth in this proposed notice to assist
us in fully considering issues and
developing policies. Referencing the file
code CMS–3297–PN and the specific
‘‘issue identifier’’ that precedes the
section on which you choose to
comment will assist us in fully
considering issues and developing
policies.
Inspection of Public Comments: All
comments received before the close of
VerDate Mar<15>2010
15:30 Jun 26, 2014
Jkt 232001
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 from an ambulatory surgical
center (ASC) provided certain
requirements are met. Section 1832
(a)(2)(F)(i) of the Social Security Act
(the Act) establishes distinct criteria for
facilities seeking designation as an ASC.
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 416 specify the minimum
conditions that an ASC must meet to
participate in the Medicare program.
Generally, to enter into an agreement,
an ASC must first be certified by a State
survey agency as complying with the
conditions or requirements set forth in
part 416 of our regulations. Thereafter,
the ASC 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 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
PO 00000
Frm 00068
Fmt 4703
Sfmt 4703
36523
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
accrediting organizations to reapply for
continued approval of its accreditation
program every 6 years or as determined
by CMS.
The Joint Commission’s current term
of approval for their ASC accreditation
program expires December 20, 2014.
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
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 the Joint
Commission’s request for continued
approval of its ASC accreditation
program. This notice also solicits public
comment on whether the Joint
Commission’s requirements meet or
exceed the Medicare conditions for
coverage (CfCs) for ASCs.
III. Evaluation of Deeming Authority
Request
The Joint Commission submitted all
the necessary materials to enable us to
make a determination concerning its
request for continued approval of its
ASC accreditation program. This
application was determined to be
E:\FR\FM\27JNN1.SGM
27JNN1
36524
Federal Register / Vol. 79, No. 124 / Friday, June 27, 2014 / Notices
wreier-aviles on DSK5TPTVN1PROD with NOTICES
complete on May 2, 2014. Under
Section 1865(a)(2) of the Act and our
regulations at § 488.8 (Federal review of
accrediting organizations), our review
and evaluation of the Joint Commission
will be conducted in accordance with,
but not necessarily limited to, the
following factors:
• The equivalency of the Joint
Commission’s standards for ASCs as
compared with our ASC CfCs.
• The Joint Commission’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 the Joint
Commission’s processes to those of
State agencies, including survey
frequency, and the ability to investigate
and respond appropriately to
complaints against accredited facilities.
++ The Joint Commission’s processes
and procedures for monitoring an ASC
found out of compliance with the Joint
Commission’s program requirements.
These monitoring procedures are used
only when the Joint Commission
identifies noncompliance. If
noncompliance is identified through
validation reviews or complaint
surveys, the State survey agency
monitors corrections as specified at
§ 488.7(d).
++ The Joint Commission’s capacity
to report deficiencies to the surveyed
facilities and respond to the facility’s
plan of correction in a timely manner.
++ The Joint Commission’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 the Joint
Commission’s staff and other resources,
and its financial viability.
++ The Joint Commission’s capacity
to adequately fund required surveys.
++ The Joint Commission’s policies
with respect to whether surveys are
announced or unannounced, to assure
that surveys are unannounced.
++ The Joint Commission’s
agreement to provide CMS with a copy
of the most current accreditation survey
together with any other information
related to the survey that we may
require (including corrective action
plans).
IV. Collection of Information
Requirements
This document does not impose
information collection requirements,
that is, no reporting, recordkeeping or
third-party disclosure requirements.
Consequently, it need not be reviewed
by the Office of Management and
VerDate Mar<15>2010
15:30 Jun 26, 2014
Jkt 232001
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 35).
V. Response to Public Comments
Because of the large number of public
comments we normally receive on
Federal Register documents, we are not
able to acknowledge or respond to them
individually. We will consider all
comments we receive by the date and
time specified in the DATES section of
this preamble, and, when we proceed
with a subsequent document, we will
respond to the comments in the
preamble to that document.
Upon completion of our evaluation,
including evaluation of comments
received as a result of this notice, we
will publish a final notice in the Federal
Register announcing the result of our
evaluation.
Dated: June 18, 2014.
Marilyn Tavenner,
Administrator, Centers for Medicare &
Medicaid Services.
[FR Doc. 2014–15101 Filed 6–26–14; 8:45 am]
BILLING CODE P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–3290–FN]
Medicare and Medicaid Programs;
Continued Approval of The Joint
Commission’s (TJC’s) Hospital
Accreditation Program
Centers for Medicare and
Medicaid Services, HHS.
ACTION: Final notice.
AGENCY:
This final notice announces
our decision to approve The Joint
Commission (TJC) for continued
recognition as a national accrediting
organization for hospitals that wish to
participate in the Medicare or Medicaid
programs. A hospital that participates in
Medicaid must also meet the Medicare
conditions of participation (CoPs) as
required under section 1905(a) of the
Social Security Act (‘‘Act’’) and 42 CFR
482.1(a)(5). This approval is effective
July 15, 2014 through July 15, 2020.
DATES: This final notice is effective July
15, 2014 through July 15, 2020.
FOR FURTHER INFORMATION CONTACT:
Monda Shaver (410) 786–3410, Cindy
Melanson, (410) 786–0310, or Patricia
Chmielewski, (410) 786–6899.
SUPPLEMENTARY INFORMATION:
SUMMARY:
PO 00000
Frm 00069
Fmt 4703
Sfmt 4703
I. Background
A healthcare provider may enter into
an agreement with Medicare to
participate in the program as a hospital
provided certain requirements are met.
Section 1861(e) of the Social Security
Act (the Act) establishes criteria for
providers seeking participation as a
hospital. Regulations concerning
Medicare provider agreements in
general are at 42 CFR part 489 and those
pertaining to the survey and
certification for Medicare participation
of providers and certain types of
suppliers are at part 488. The
regulations at part 482 specify the
specific conditions that a provider must
meet to participate in the Medicare
program as a hospital.
Generally, to enter into a Medicare
hospital provider agreement, a facility
must first be certified as complying with
the conditions set forth in part 482 and
recommended to us for participation by
a state survey agency. Thereafter, the
hospital is subject to periodic surveys
by a state survey agency to determine
whether it continues to meet these
conditions. However, there is an
alternative to certification surveys by
state agencies. Accreditation by a
nationally recognized Medicare
accreditation program approved by us
may substitute for both initial and
ongoing state review.
Section 1865(a)(1) of the Act provides
that, if the Secretary finds that
accreditation of a provider entity by an
approved national accrediting
organization meets or exceeds all
applicable Medicare conditions, we may
treat the provider entity as having met
those conditions, that is, we may
‘‘deem’’ the provider entity to be in
compliance. Accreditation by an
accrediting organization is voluntary
and is not required for Medicare
participation.
Part 488, subpart A, implements the
provisions of section 1865 and requires
that a national accrediting organization
applying for approval of its Medicare
accreditation program must provide us
with reasonable assurance that the
accrediting organization requires its
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 Medicare
accreditation program every 6 years or
sooner as determined by us. TJC’s
current term of approval as a recognized
E:\FR\FM\27JNN1.SGM
27JNN1
Agencies
[Federal Register Volume 79, Number 124 (Friday, June 27, 2014)]
[Notices]
[Pages 36522-36524]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-15101]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-3297-PN]
Medicare and Medicaid Programs: Application From the Joint
Commission for Continued Approval of Its Ambulatory Surgical Center
Accreditation Program
AGENCY: Centers for Medicare and Medicaid Services, HHS.
ACTION: Proposed notice.
-----------------------------------------------------------------------
SUMMARY: This proposed notice acknowledges the receipt of an
application from the Joint Commission for continued recognition as a
national accrediting organization for ambulatory surgical centers
(ASCs) 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 July 28, 2014.
ADDRESSES: In commenting, please refer to file code CMS-3297-PN.
Because of staff and resource limitations, we cannot accept comments by
facsimile (FAX) transmission.
You may submit comments in one of four ways:
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 (one original and
two copies) to the following address ONLY: Centers for Medicare &
Medicaid Services, Department of Health and Human Services, Attention:
CMS-3297-PN, P.O. Box 8016, Baltimore, MD 21244-8010.
[[Page 36523]]
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-3297-PN, Mail
Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.
4. By hand or courier. Alternatively, you may deliver (by hand or
courier) your written comments 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.)
Comments erroneously mailed to the addresses indicated as
appropriate for hand or courier delivery may be delayed and received
after the comment period.
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.
For information on viewing public comments, see the beginning of
the SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT: Monda Shaver, (410) 786-3410. Cindy
Melanson, (410) 786-0310. Patricia Chmielewski, (410) 786-6899.
SUPPLEMENTARY INFORMATION:
Submitting Comments: We welcome comments from the public on all
issues set forth in this proposed notice to assist us in fully
considering issues and developing policies. Referencing the file code
CMS-3297-PN and the specific ``issue identifier'' that precedes the
section on which you choose to comment will assist us in fully
considering issues and developing policies.
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 from an ambulatory surgical center (ASC) provided
certain requirements are met. Section 1832 (a)(2)(F)(i) of the Social
Security Act (the Act) establishes distinct criteria for facilities
seeking designation as an ASC. 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 416 specify the minimum
conditions that an ASC must meet to participate in the Medicare
program.
Generally, to enter into an agreement, an ASC must first be
certified by a State survey agency as complying with the conditions or
requirements set forth in part 416 of our regulations. Thereafter, the
ASC 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 of
the Department of Health and Human Services (the Secretary) as having
standards for accreditation that meet or exceed Medicare requirements,
any provider entity accredited by the national accrediting body's
approved program would be deemed to meet the Medicare conditions. A
national accrediting organization applying for approval of its
accreditation program under part 488, subpart A, must provide 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
accrediting organizations to reapply for continued approval of its
accreditation program every 6 years or as determined by CMS.
The Joint Commission's current term of approval for their ASC
accreditation program expires December 20, 2014.
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 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 the
Joint Commission's request for continued approval of its ASC
accreditation program. This notice also solicits public comment on
whether the Joint Commission's requirements meet or exceed the Medicare
conditions for coverage (CfCs) for ASCs.
III. Evaluation of Deeming Authority Request
The Joint Commission submitted all the necessary materials to
enable us to make a determination concerning its request for continued
approval of its ASC accreditation program. This application was
determined to be
[[Page 36524]]
complete on May 2, 2014. 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 the Joint Commission will
be conducted in accordance with, but not necessarily limited to, the
following factors:
The equivalency of the Joint Commission's standards for
ASCs as compared with our ASC CfCs.
The Joint Commission'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 the Joint Commission's processes to those
of State agencies, including survey frequency, and the ability to
investigate and respond appropriately to complaints against accredited
facilities.
++ The Joint Commission's processes and procedures for monitoring
an ASC found out of compliance with the Joint Commission's program
requirements. These monitoring procedures are used only when the Joint
Commission 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).
++ The Joint Commission's capacity to report deficiencies to the
surveyed facilities and respond to the facility's plan of correction in
a timely manner.
++ The Joint Commission'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 the Joint Commission's staff and other
resources, and its financial viability.
++ The Joint Commission's capacity to adequately fund required
surveys.
++ The Joint Commission's policies with respect to whether surveys
are announced or unannounced, to assure that surveys are unannounced.
++ The Joint Commission's agreement to provide CMS with a copy of
the most current accreditation survey together with any other
information related to the survey that we may require (including
corrective action plans).
IV. Collection of Information Requirements
This document does not impose information collection requirements,
that is, no reporting, recordkeeping or third-party disclosure
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).
V. Response to Public Comments
Because of the large number of public comments we normally receive
on Federal Register documents, we are not able to acknowledge or
respond to them individually. We will consider all comments we receive
by the date and time specified in the DATES section of this preamble,
and, when we proceed with a subsequent document, we will respond to the
comments in the preamble to that document.
Upon completion of our evaluation, including evaluation of comments
received as a result of this notice, we will publish a final notice in
the Federal Register announcing the result of our evaluation.
Dated: June 18, 2014.
Marilyn Tavenner,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2014-15101 Filed 6-26-14; 8:45 am]
BILLING CODE P