Medicare and Medicaid Programs; Continued Approval of the Accreditation Commission for Health Care Accreditation Program, 64902-64904 [2019-25429]
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64902
Federal Register / Vol. 84, No. 227 / Monday, November 25, 2019 / Notices
in accordance with CMS’s strategic plan
and the Government Performance and
Results Act (GPRA) goals and
performance measures.
• Acts as liaison to the Department of
Health and Human Services (HHS),
Assistant Secretary for Financial
Resources, Office of Management and
Budget (OMB), and the Congressional
appropriations committees for all
matters concerning CMS’s operating
budget.
• Manages the Medicare financial
management system, the Medicare
contractors’ budgets, Quality
Improvement Organizations’ budgets,
research budgets, managed care
payments, the issuance of State
Medicaid grants, and the funding of the
State survey/certification and the
Clinical Laboratory and Improvement
Act programs. Is responsible for all CMS
disbursements.
• Maintains CMS financial data and
prepares external reports to other
agencies such as HHS, Treasury, OMB,
Internal Revenue Service, General
Services Administration, related to
CMS’s obligations, expenditures,
prompt payment activities, debt and
cash management, and other
administrative functions.
• Performs cash management
activities and establishes and maintains
systems to control the obligation of
funds and ensure that the AntiDeficiency Act is not violated.
• Manages the Medicare Secondary
Payer Program and Medicare Debt
Resolution activities.
• Develops CMS policies governing
both Medicare Secondary Payer and
Medicaid Third Party Liability.
• Oversees the Medicare fee-forservice and the Medicaid and CHIP
improper payment measurement
programs to measure payment accuracy.
• Develops and publishes the
Medicare Fee-For-Service, Medicaid,
and Children’s Health Insurance Error
Rate. Develops improper payment
measurement methodologies to report
related Marketplaces and related
programs.
• Manages, develops, and enhances
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system, the Healthcare Integrated
General Ledger Accounting System
(HIGLAS), which tracks the financial
activity and transactions of all of CMS’s
programs.
• Manages the development to
maintain information technology
program systems that support
accounting operations, for the Medicare
Benefits, Medicare Secondary Payer,
Marketplace, Medicaid, CHIP Grants,
and Administrative Program Accounting
lines of business.
VerDate Sep<11>2014
17:31 Nov 22, 2019
Jkt 250001
• Coordinates the development and
monitoring of all audit corrective action
plans and the Office of the Inspector
General (OIG) clearance documents that
address each OIG and the Government
Accountability Office agreed upon
recommendations.
• Develops an enterprise risk
assessment program to better support
CMS programs.
• Works collaboratively with
components and contracting officials to
review contract language and contract
cost estimates in order to develop
contract-specific performance and
financial information.
• Coordinates performance
management and promotes the use of
Agency performance measures to foster
a more results-orientated performance
culture through CMS.
• Ensures compliance with a number
of agency performance requirements
such as GPRA and the GPRA
Modernization Act, OMB program
analysis and the Department strategic
plan priorities.
management on the conduct of labormanagement negotiations. Coordinates
and develops CMS-wide policy
regarding the development,
implementation, and evaluation of labor
relations’ activities.
• Provides managers and senior
Agency officials (in accordance with
Federal Service Labor-Management
Relations statue(s), and Master Labor
Agreement) with advice and assistance
on activities associated with labor
management relations, including but not
limited to bargaining unit status
determinations, unfair labor practices,
negotiability issues, workplace changes
affecting bargaining unit employees, and
case work associated with labor
relations activities, (e.g., grievances).
• Develops and coordinates the
policies and procedures necessary to
implement the CMS Ethics Program.
Provides advice and guidance to the
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concerning all issues that must be
considered by the DEC.
Office of Human Capital
• Administers CMS’s special hiring
authorities, diversity hiring initiatives,
Delegated Examining authority and
internal Merit Promotion program, and
recruitment and retention programs,
including negotiating base salary and
any appropriate special hiring
incentives.
• Collects, analyzes and coordinates
strategic planning data for use by CMS
for recruitment purposes. Uses data to
focus recruitment efforts.
• Provides leadership for the
development and implementation of
CMS Leadership and Management
Development Programs. Coordinates
management development activities
with the Leadership Development and
Recognition Board.
• Manages and oversees CMS
learning management systems and
coordinates with DHHS on departmentwide courses.
• Administers plans, develops,
directs, coordinates and evaluates
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performance management, delegations
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guidance, and develops and implements
guidance and educational tools to
support successful administration of
these programs.
• Provides oversight of collective
bargaining agreements and provision of
advisory services to CMS managers.
Conducts negotiations on behalf of
management and/or advises
Dated: November 18, 2019.
Seema Verma,
Administrator, Centers for Medicare &
Medicaid Services.
PO 00000
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Authority: 44 U.S.C. 3101.
[FR Doc. 2019–25426 Filed 11–20–19; 4:15 pm]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–3379–FN]
Medicare and Medicaid Programs;
Continued Approval of the
Accreditation Commission for Health
Care Accreditation Program
Centers for Medicare &
Medicaid Services, HHS.
ACTION: Final notice.
AGENCY:
This final notice announces
our decision to approve the
Accreditation Commission for Health
Care (ACHC) for continued recognition
as a national accrediting organization
for hospices that wish to participate in
the Medicare or Medicaid programs. A
hospice that participates in Medicaid
must also meet the Medicare conditions
for participation.
DATES: This final notice is effective
November 27, 2019 through November
27, 2025.
FOR FURTHER INFORMATION CONTACT:
Lillian Williams, (410) 786–8636, or
Joann Fitzell, (410) 786–4280.
SUPPLEMENTARY INFORMATION:
SUMMARY:
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Federal Register / Vol. 84, No. 227 / Monday, November 25, 2019 / Notices
I. Background
Under the Medicare program, eligible
beneficiaries may receive covered
services in a hospice provided certain
requirements are met by the hospice.
Section 1861(dd) of the Social Security
Act (the Act) establishes distinct criteria
for facilities seeking designation as a
hospice. 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 418 specify
the conditions that a hospice must meet
in order to participate in the Medicare
program, the scope of covered services
and the conditions for Medicare
payment for hospices.
Generally, to enter into an agreement,
a hospice must first be certified as
complying with the conditions set forth
in part 418 and recommended to the
Center for Medicare & Medicaid (CMS)
for participation by a state survey
agency. Thereafter, the hospice 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 CMS may substitute for
both initial and ongoing state review.
Section 1865(a)(1) of the Act provides
that, if the Secretary of the Department
of Health and Human Services (the
Secretary) finds that accreditation of a
provider entity by an approved national
accrediting organization meets or
exceeds all applicable Medicare
conditions, CMS may treat the provider
entity as having met those conditions,
that is, may ‘‘deem’’ the provider entity
to be in compliance. 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 organization’s
approved program may be deemed to
meet the Medicare conditions. A
national accrediting organization
applying for CMS approval of their
accreditation program under 42 CFR
part 488, subpart A, must provide CMS
with reasonable assurance that the
accrediting organization requires the
accredited provider entities to meet
requirements that are at least as
stringent as the Medicare conditions.
Our regulations concerning the approval
of accrediting organizations are set forth
VerDate Sep<11>2014
17:31 Nov 22, 2019
Jkt 250001
at § 488.5. Section 488.5(e)(2)(i) requires
accrediting organizations to reapply for
continued approval of its Medicare
accreditation program every 6 years or
sooner as determined by CMS. The
Accreditation Commission for Health
Care (ACHC’S) term of approval as a
recognized accreditation program for its
hospice accreditation program expires
November 27, 2019.
II. Application Approval Process
Section 1865(a)(3)(A) of the Act
provides a statutory timetable to ensure
that our review of applications for CMSapproval of an accreditation program is
conducted in a timely manner. The Act
provides us 210 days after the date of
receipt of a complete application to
publish notice in the Federal Register of
approval or denial of the application.
The Act also states within 60 days after
receiving a complete application, we
must publish a notice in the Federal
Register that identifies the national
accrediting body making the request,
describes the request, and provides no
less than a 30-day public comment
period.
III. Provisions of the Proposed Notice
In the June 28, 2019 Federal Register
(84 FR 31068), we published a proposed
notice announcing ACHC’s request for
continued approval of its Medicare
hospice accreditation program. In the
June 28, 2019 proposed notice, we
detailed our evaluation criteria. Under
section 1865(a)(2) of the Act and in our
regulations at § 488.5, we conducted a
review of ACHC’s Medicare hospice
accreditation application in accordance
with the criteria specified by our
regulations, which include, but are not
limited to the following:
• An onsite administrative review of
ACHC’s: (1) Corporate policies; (2)
financial and human resources available
to accomplish the proposed surveys; (3)
procedures for training, monitoring, and
evaluation of its hospice surveyors; (4)
ability to investigate and respond
appropriately to complaints against
accredited hospices; and (5) survey
review and decision-making process for
accreditation.
• The comparison of ACHC’s
Medicare hospice accreditation program
standards to CMS’s current Medicare
hospice conditions of participation.
• A documentation review of ACHC’s
survey process to—
++ Determine the composition of the
survey team, surveyor qualifications,
and ACHC’s ability to provide
continuing surveyor training.
++ Compare ACHC’s processes to
those we require of state survey
agencies, including periodic resurvey
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Fmt 4703
Sfmt 4703
64903
and the ability to investigate and
respond appropriately to complaints
against accredited hospices.
++ Evaluate ACHC’s procedures for
monitoring hospices it has found to be
out of compliance with ACHC’s program
requirements. (This pertains only to
monitoring procedures when ACHC
identifies non-compliance. If
noncompliance is identified by a state
survey agency through a validation
survey, the state survey agency monitors
corrections as specified at § 488.9(c))
++ Assess ACHC’s ability to report
deficiencies to the surveyed hospice and
respond to the hospice’s plan of
correction in a timely manner.
++ Establish ACHC’s ability to
provide CMS with electronic data and
reports necessary for effective validation
and assessment of the organization’s
survey process.
++ Determine the adequacy of
ACHC’s staff and other resources.
++ Confirm ACHC’s ability to provide
adequate funding for performing
required surveys.
++ Confirm ACHC’s policies with
respect to surveys being unannounced.
++ ACHC’s policies and procedures
to avoid conflicts of interest, including
the appearance of conflicts of interest,
involving individuals who conduct
surveys or participate in accreditation
decisions.
++ Obtain ACHC’s agreement to
provide CMS with a copy of the most
current accreditation survey together
with any other information related to
the survey as we may require, including
corrective action plans.
In accordance with section
1865(a)(3)(A) of the Act, the June 28,
2019 proposed notice also solicited
public comments regarding whether
ACHC’s requirements met or exceeded
the Medicare CoPs for hospices. No
comments were received in response to
the proposed notice.
IV. Provisions of the Final Notice
A. Differences Between ACHC’s
Standards and Requirements for
Accreditation and Medicare Conditions
and Survey Requirements
We compared ACHC’s hospice
accreditation requirements and survey
process with the Medicare CoPs of part
418, and the survey and certification
process requirements of parts 488 and
489. Our review and evaluation of
ACHC’s hospice application, which
were conducted as described in section
III of this final notice, yielded the
following areas where, as of the date of
this notice, ACHC has completed
revising its standards and certification
processes in order to meet the
requirements at:
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64904
Federal Register / Vol. 84, No. 227 / Monday, November 25, 2019 / Notices
• § 418.56(c)(2), to address the
requirement the frequency of services
necessary to meet the specific patient
and family needs.
• § 418.110(c)(1), to require an
inpatient hospice to address real or
potential threats to the health and safety
of the patients, others, and property.
• § 418.110)(d)(1)(i), to address the
requirement that hospice must meet
applicable provisions and must proceed
in accordance with the Life Safety Code
(National Fire Protection Association
(NFPA) 101 and Tentative Interim
amendments TIA 12–1, TIA 12–2, TIA
12–3 and TIA 12–4.)
• § 418.110(d)(5), to address the
requirement when a sprinkler system is
shut down for more than 10 hours.
• § 418.110(d)(5)(i), to address the
requirement to evacuate the building or
portion of the building affected by the
system outage until the system is back
in service.
• § 418.110(d)(5)(ii), to address the
requirement to establish a fire watch
until the system is back in service.
• § 418.110(d)(6), to require both
existing and new buildings to have an
outside window or door in every
sleeping room and, for any building
constructed after July 5, 2016, to require
that the sill height must not exceed 36
inches above the floor.
• § 418.110(e), to address the
requirement that except as otherwise
provided in this section, the hospice
must meet the applicable provisions and
must proceed in accordance with the
Health Care Facilities Code (NFPA 99
and Tentative Interim Amendments TIA
12–2, TIA 12–3, TIA 12–4, TIA 12–5
and TIA 12–6).
• § 418.11(e)(1), to address the
requirement that Chapters 7, 8, 12, and
13 of the adopted Health Care Facilities
Code do not apply to a hospice.
• § 418.110(e)(2), to address the
requirement that if application of the
Health Care Facilities Code required
under paragraph (e) of this section
would result in unreasonable hardship
for hospice, CMS may waive specific
provisions of the Health Care Facilities
Code, but only if the waiver does not
adversely affect the health and safety of
patients.
• § 418.110(q) through
§ 418.110(q)(1)(xi), address the
requirement that the standards
incorporated by reference in this section
are approved for incorporation by
reference by the Director of the Office of
the Federal Register in accordance with
5 U.S.C 552(a) and 1 CFR part 51.
B. Term of Approval
Based on our review and observations
described in section III of this final
VerDate Sep<11>2014
17:31 Nov 22, 2019
Jkt 250001
notice, we approve ACHC as a national
accreditation organization for hospices
that request participation in the
Medicare program, effective November
27, 2019 through November 27, 2025.
V. Collection of Information
Requirements
This document does not impose
information collection requirements,
that is, reporting recordkeeping or thirdparty disclosure requirements.
Consequently, there is no need for
review by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 35 et seq.).
Dated: November 5, 2019.
Seema Verma,
Administrator, Centers for Medicare &
Medicaid Services.
[FR Doc. 2019–25429 Filed 11–22–19; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–3390–PN]
Medicare Program; Application From
Accreditation Commission for Health
Care for Initial CMS-Approval of Its
Home Infusion Therapy Accreditation
Program
Centers for Medicare and
Medicaid Services, HHS.
ACTION: Notice with request for
comment.
AGENCY:
This proposed notice
acknowledges the receipt of an
application from Accreditation
Commission for Health Care for initial
recognition as a national accrediting
organization for suppliers of home
infusion therapy services that wish to
participate in the Medicare program.
The statute requires that within 60 days
of receipt of an organization’s complete
application, the Centers for Medicare &
Medicaid Services (CMS) publish 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.
DATES: To be assured consideration,
comments must be received at one of
the addresses provided below, no later
than 5 p.m. on December 26, 2019.
ADDRESSES: In commenting, please refer
to file code CMS–3390–PN. Because of
staff and resource limitations, we cannot
accept comments by facsimile (FAX)
transmission.
SUMMARY:
PO 00000
Frm 00085
Fmt 4703
Sfmt 4703
Comments, including mass comment
submissions, must be submitted in one
of the following three ways (please
choose only one of the ways listed):
1. Electronically. You may submit
electronic comments on this regulation
to 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–3390–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–3390–PN,
Mail Stop C4–26–05, 7500 Security
Boulevard, Baltimore, MD 21244–1850.
For information on viewing public
comments, see the beginning of the
SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT:
Christina Mister-Ward, (410)786–2441
Lillian Williams, (410)786–8636.
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments: All
comments received before the close of
the comment period are available for
viewing by the public, including any
personally identifiable or confidential
business information that is included in
a comment. We post all comments
received before the close of the
comment period on the following
website as soon as possible after they
have been received: https://
www.regulations.gov . Follow the search
instructions on that website to view
public comments.
I. Background
Home infusion therapy (HIT) is a
treatment option for Medicare
beneficiaries with a wide range of acute
and chronic conditions. Section 5012 of
the 21st Century Cures Act (Pub. L. 114–
255, enacted December 13, 2016) added
section 1861(iii) to the Social Security
Act (the Act), establishing a new
Medicare benefit for HIT services.
Section 1861(iii)(1) of the Act defines
‘‘home infusion therapy’’ as professional
services, including nursing services;
training and education not otherwise
covered under the Durable Medical
Equipment (DME) benefit; remote
monitoring; and other monitoring
services. Home infusion therapy must
be furnished by a qualified HIT supplier
and furnished in the individual’s home.
The individual must:
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]]>Agencies
[Federal Register Volume 84, Number 227 (Monday, November 25, 2019)]
[Notices]
[Pages 64902-64904]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-25429]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-3379-FN]
Medicare and Medicaid Programs; Continued Approval of the
Accreditation Commission for Health Care Accreditation Program
AGENCY: Centers for Medicare & Medicaid Services, HHS.
ACTION: Final notice.
-----------------------------------------------------------------------
SUMMARY: This final notice announces our decision to approve the
Accreditation Commission for Health Care (ACHC) for continued
recognition as a national accrediting organization for hospices that
wish to participate in the Medicare or Medicaid programs. A hospice
that participates in Medicaid must also meet the Medicare conditions
for participation.
DATES: This final notice is effective November 27, 2019 through
November 27, 2025.
FOR FURTHER INFORMATION CONTACT: Lillian Williams, (410) 786-8636, or
Joann Fitzell, (410) 786-4280.
SUPPLEMENTARY INFORMATION:
[[Page 64903]]
I. Background
Under the Medicare program, eligible beneficiaries may receive
covered services in a hospice provided certain requirements are met by
the hospice. Section 1861(dd) of the Social Security Act (the Act)
establishes distinct criteria for facilities seeking designation as a
hospice. 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 418 specify the conditions that a hospice must meet in
order to participate in the Medicare program, the scope of covered
services and the conditions for Medicare payment for hospices.
Generally, to enter into an agreement, a hospice must first be
certified as complying with the conditions set forth in part 418 and
recommended to the Center for Medicare & Medicaid (CMS) for
participation by a state survey agency. Thereafter, the hospice 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
CMS may substitute for both initial and ongoing state review.
Section 1865(a)(1) of the Act provides that, if the Secretary of
the Department of Health and Human Services (the Secretary) finds that
accreditation of a provider entity by an approved national accrediting
organization meets or exceeds all applicable Medicare conditions, CMS
may treat the provider entity as having met those conditions, that is,
may ``deem'' the provider entity to be in compliance. 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 organization's approved program may be deemed to meet the
Medicare conditions. A national accrediting organization applying for
CMS approval of their accreditation program under 42 CFR part 488,
subpart A, must provide CMS with reasonable assurance that the
accrediting organization requires the accredited provider entities to
meet requirements that are at least as stringent as the Medicare
conditions. Our regulations concerning the approval of accrediting
organizations are set forth at Sec. 488.5. Section 488.5(e)(2)(i)
requires accrediting organizations to reapply for continued approval of
its Medicare accreditation program every 6 years or sooner as
determined by CMS. The Accreditation Commission for Health Care
(ACHC'S) term of approval as a recognized accreditation program for its
hospice accreditation program expires November 27, 2019.
II. Application Approval Process
Section 1865(a)(3)(A) of the Act provides a statutory timetable to
ensure that our review of applications for CMS-approval of an
accreditation program is conducted in a timely manner. The Act provides
us 210 days after the date of receipt of a complete application to
publish notice in the Federal Register of approval or denial of the
application. The Act also states within 60 days after receiving a
complete application, we must publish a notice in the Federal Register
that identifies the national accrediting body making the request,
describes the request, and provides no less than a 30-day public
comment period.
III. Provisions of the Proposed Notice
In the June 28, 2019 Federal Register (84 FR 31068), we published a
proposed notice announcing ACHC's request for continued approval of its
Medicare hospice accreditation program. In the June 28, 2019 proposed
notice, we detailed our evaluation criteria. Under section 1865(a)(2)
of the Act and in our regulations at Sec. 488.5, we conducted a review
of ACHC's Medicare hospice accreditation application in accordance with
the criteria specified by our regulations, which include, but are not
limited to the following:
An onsite administrative review of ACHC's: (1) Corporate
policies; (2) financial and human resources available to accomplish the
proposed surveys; (3) procedures for training, monitoring, and
evaluation of its hospice surveyors; (4) ability to investigate and
respond appropriately to complaints against accredited hospices; and
(5) survey review and decision-making process for accreditation.
The comparison of ACHC's Medicare hospice accreditation
program standards to CMS's current Medicare hospice conditions of
participation.
A documentation review of ACHC's survey process to--
++ Determine the composition of the survey team, surveyor
qualifications, and ACHC's ability to provide continuing surveyor
training.
++ Compare ACHC's processes to those we require of state survey
agencies, including periodic resurvey and the ability to investigate
and respond appropriately to complaints against accredited hospices.
++ Evaluate ACHC's procedures for monitoring hospices it has found
to be out of compliance with ACHC's program requirements. (This
pertains only to monitoring procedures when ACHC identifies non-
compliance. If noncompliance is identified by a state survey agency
through a validation survey, the state survey agency monitors
corrections as specified at Sec. 488.9(c))
++ Assess ACHC's ability to report deficiencies to the surveyed
hospice and respond to the hospice's plan of correction in a timely
manner.
++ Establish ACHC's ability to provide CMS with electronic data and
reports necessary for effective validation and assessment of the
organization's survey process.
++ Determine the adequacy of ACHC's staff and other resources.
++ Confirm ACHC's ability to provide adequate funding for
performing required surveys.
++ Confirm ACHC's policies with respect to surveys being
unannounced.
++ ACHC's policies and procedures to avoid conflicts of interest,
including the appearance of conflicts of interest, involving
individuals who conduct surveys or participate in accreditation
decisions.
++ Obtain ACHC's agreement to provide CMS with a copy of the most
current accreditation survey together with any other information
related to the survey as we may require, including corrective action
plans.
In accordance with section 1865(a)(3)(A) of the Act, the June 28,
2019 proposed notice also solicited public comments regarding whether
ACHC's requirements met or exceeded the Medicare CoPs for hospices. No
comments were received in response to the proposed notice.
IV. Provisions of the Final Notice
A. Differences Between ACHC's Standards and Requirements for
Accreditation and Medicare Conditions and Survey Requirements
We compared ACHC's hospice accreditation requirements and survey
process with the Medicare CoPs of part 418, and the survey and
certification process requirements of parts 488 and 489. Our review and
evaluation of ACHC's hospice application, which were conducted as
described in section III of this final notice, yielded the following
areas where, as of the date of this notice, ACHC has completed revising
its standards and certification processes in order to meet the
requirements at:
[[Page 64904]]
Sec. 418.56(c)(2), to address the requirement the
frequency of services necessary to meet the specific patient and family
needs.
Sec. 418.110(c)(1), to require an inpatient hospice to
address real or potential threats to the health and safety of the
patients, others, and property.
Sec. 418.110)(d)(1)(i), to address the requirement that
hospice must meet applicable provisions and must proceed in accordance
with the Life Safety Code (National Fire Protection Association (NFPA)
101 and Tentative Interim amendments TIA 12-1, TIA 12-2, TIA 12-3 and
TIA 12-4.)
Sec. 418.110(d)(5), to address the requirement when a
sprinkler system is shut down for more than 10 hours.
Sec. 418.110(d)(5)(i), to address the requirement to
evacuate the building or portion of the building affected by the system
outage until the system is back in service.
Sec. 418.110(d)(5)(ii), to address the requirement to
establish a fire watch until the system is back in service.
Sec. 418.110(d)(6), to require both existing and new
buildings to have an outside window or door in every sleeping room and,
for any building constructed after July 5, 2016, to require that the
sill height must not exceed 36 inches above the floor.
Sec. 418.110(e), to address the requirement that except
as otherwise provided in this section, the hospice must meet the
applicable provisions and must proceed in accordance with the Health
Care Facilities Code (NFPA 99 and Tentative Interim Amendments TIA 12-
2, TIA 12-3, TIA 12-4, TIA 12-5 and TIA 12-6).
Sec. 418.11(e)(1), to address the requirement that
Chapters 7, 8, 12, and 13 of the adopted Health Care Facilities Code do
not apply to a hospice.
Sec. 418.110(e)(2), to address the requirement that if
application of the Health Care Facilities Code required under paragraph
(e) of this section would result in unreasonable hardship for hospice,
CMS may waive specific provisions of the Health Care Facilities Code,
but only if the waiver does not adversely affect the health and safety
of patients.
Sec. 418.110(q) through Sec. 418.110(q)(1)(xi), address
the requirement that the standards incorporated by reference in this
section are approved for incorporation by reference by the Director of
the Office of the Federal Register in accordance with 5 U.S.C 552(a)
and 1 CFR part 51.
B. Term of Approval
Based on our review and observations described in section III of
this final notice, we approve ACHC as a national accreditation
organization for hospices that request participation in the Medicare
program, effective November 27, 2019 through November 27, 2025.
V. Collection of Information Requirements
This document does not impose information collection requirements,
that is, reporting recordkeeping or third-party disclosure
requirements. Consequently, there is no need for review by the Office
of Management and Budget under the authority of the Paperwork Reduction
Act of 1995 (44 U.S.C. 35 et seq.).
Dated: November 5, 2019.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2019-25429 Filed 11-22-19; 8:45 am]
BILLING CODE 4120-01-P
