Federal Register / Vol. 86, No. 38 / Monday, March 1, 2021 / Notices 12005 

Dated: February 24, 2021. 

Lynette Wilson, 

Federal Liaison, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 2021–04130 Filed 2–25–21; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–3400–FN] 

Medicare and Medicaid Programs; 

Application From the Accreditation 

Commission for Health Care (ACHC) 

for Continued Approval of its Home 

Health Agency Accreditation Program 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human 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 home health agencies (HHAs) that 

wish to participate in the Medicare or 

Medicaid programs. An HHA that 

participates in Medicaid must also meet 

the Medicare conditions of participation 

(CoPs). 

DATES: This decision announced in this 

final notice is effective February 24, 

2021 through February 24, 2025. 

FOR FURTHER INFORMATION CONTACT: Tara 

Lemons (410) 786–3030. Lillian 

Williams (410) 786–8636. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Under the Medicare program, eligible 

beneficiaries may receive covered 

services from a home health agency 

(HHA), provided certain requirements 

are met. Sections 1861(m) and (o), 1891 

and 1895 of the Social Security Act (the 

Act) establish distinct criteria for an 

entity seeking designation as an HHA. 

Regulations concerning provider 

agreements are at 42 CFR part 489 and 

those pertaining to activities relating to 

the survey and certification of facilities 

and other entities are at 42 CFR part 

488. The regulations at 42 CFR parts 409 

and 484 specify the conditions that an 

HHA must meet to participate in the 

Medicare program, the scope of covered 

services and the conditions for Medicare 

payment for home health care. 

Generally, to enter into a provider 

agreement with the Medicare program, 

an HHA must first be certified by a state 

survey agency as complying with the 

conditions or requirements set forth in 

42 CFR part 484 of our regulations. 

Thereafter, the HHA is subject to regular 

surveys by a state survey agency to 

determine whether it continues to meet 

these requirements. 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 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 our 

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 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 

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 § 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 

for their HHA accreditation program 

expires February 24, 2021. 

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, with 

any documentation necessary to make 

the determination, to complete our 

survey activities and application 

process. 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. At the end 

of the 210-day period, we must publish 

a notice in the Federal Register 

approving or denying the application. 

III. Provisions of the Proposed Notice 

In the September 28, 2020 Federal 

Register (85 FR 60796), we published a 

proposed notice announcing ACHC’s 

request for continued approval of its 

Medicare HHA accreditation program. 

In the September 28, 2020 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 

HHA accreditation application in 

accordance with the criteria specified by 

our regulations, which include, but are 

not limited to the following: 

• An 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 HHA surveyors; (4) 

ability to investigate and respond 

appropriately to complaints against 

accredited HHAs; and (5) survey review 

and decision-making process for 

accreditation. 

• The comparison of ACHC’s 

Medicare HHA accreditation program 

standards to our current Medicare 

conditions of participation (CoPs) for 

HHAs. 

• A documentation review of ACHC’s 

survey process to do the following: 

++ 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 HHAs. 

++ Evaluate ACHC’s procedures for 

monitoring HHAs 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 HHAs and 

respond to the HHAs 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. 

12006 Federal Register / Vol. 86, No. 38 / Monday, March 1, 2021 / Notices 

++ 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. 

++ Confirm 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 September 

28, 2020 proposed notice also solicited 

public comments regarding whether 

ACHC’s requirements met or exceeded 

the Medicare CoPs for HHAs. No 

comments were received in response to 

our 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 HHA 

accreditation requirements and survey 

process with the Medicare CoPs of parts 

409 and 484, and the survey and 

certification process requirements of 

parts 488 and 489. Our review and 

evaluation of ACHC’s HHA 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 following 

requirements: 

• Section 484.102(b) to include the 

requirement to review and update 

emergency preparedness policies and 

procedures at least every 2 years. 

• Section 484.105(b)(1)(i) to ensure 

that the administrator is appointed by 

and reports to the governing body. 

• Section 488.26(b) to ensure 

surveyor documentation relating to noncompliance with particular Medicare 

conditions reflects the manner and 

degree of non-compliance, cited at the 

appropriate level (that is, condition 

versus standard level). 

• Section 488.5(a)(4)(vii) to describe 

ACHC’s procedures and timelines for 

monitoring provider’s or supplier’s 

correction of identified non-compliance 

with relevant standards, including the 

criteria ACHC uses to determine when 

a desk review versus an on-site review 

would be acceptable for monitoring the 

correction of non-compliance. 

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 HHAs that 

request participation in the Medicare 

program, effective February 24, 2021 

through February 24, 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. 3501 et seq.). 

The Acting Administrator of the 

Centers for Medicare & Medicaid 

Services (CMS), Elizabeth Richter, 

having reviewed and approved this 

document, authorizes Lynette Wilson, 

who is the Federal Register Liaison, to 

electronically sign this document for 

purposes of publication in the Federal 

Register. 

Dated: February 24, 2021. 

Lynette Wilson, 

Federal Register Liaison, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2021–04169 Filed 2–26–21; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Submission for OMB Review; 

Comment Request; Healthy Marriage 

and Responsible Fatherhood 

Performance Measures and Additional 

Data Collection (New Collection) 

AGENCY: Office of Planning, Research, 

and Evaluation, Administration for 

Children and Families, HHS. 

ACTION: Request for public comment. 

SUMMARY: The Administration for 

Children and Families (ACF), Office of 

Family Assistance (OFA) has had 

administrative responsibility for federal 

funding of programs that strengthen 

families through healthy marriage and 

relationship education and responsible 

fatherhood programming since 2006, 

through the Healthy Marriage (HM) and 

Responsible Fatherhood (RF) Grant 

Programs. ACF required the 2015 cohort 

of HMRF grantees—which received 5- 

year grants in September 2015—to 

collect and report performance 

measures about program operations, 

services, and clients served (OMB 

#0970–0460). A performance measures 

data collection system called nFORM 

(Information, Family Outcomes, 

Reporting, and Management) was 

implemented with the 2015 cohort to 

improve the efficiency of data collection 

and reporting and the quality of data. 

This system allows for streamlined and 

standardized submission of grantee 

performance data through regular 

progress reports and supports granteeled and federal research projects. ACF 

will continue performance measure and 

other data collection activities for the 

HMRF grant program with a new cohort 

of grantees who received 5-year awards 

in September 2020. ACF is requesting 

comment on a new data collection to 

support these activities with the 2020 

HMRF grantee cohort. ACF has made 

changes to the previous cohort’s data 

collection instruments and performance 

reports for use in the new cohort. This 

new grantee cohort is expected to begin 

collecting performance measure data 

and reporting to ACF in April 2021. 

DATES: Comments due within 30 days of 

publication. OMB must make a decision 

about the collection of information 

between 30 and 60 days after 

publication of this document in the 

Federal Register. Therefore, a comment 

is best assured of having its full effect 

if OMB receives it within 30 days of 

publication. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. 

SUPPLEMENTARY INFORMATION: 

Description: ACF proposes to collect a 

set of performance measures from all 

HMRF grantees. These measures collect 

standardized information in the 

following areas: 

• Applicant characteristics; 

• Program operations; 

• Service delivery; and 

• Participant outcomes: 

Æ Entrance survey, with five versions: 

(1) HM Program Entrance Survey for 

Adult-Focused Programs; (2) HM 

Program Entrance Survey for YouthFocused Programs; (3) RF Program 

Entrance Survey for Community-Based 

Fathers; (4) RF Program Entrance Survey 

for Community-Based Mothers; and (5)