Federal Register / Vol. 78, No. 183 / Friday, September 20, 2013 / Notices 57857 

About ASPR 

ASPR leads HHS in preparing the 

nation to respond to and recover from 

adverse health effects of emergencies, 

supporting communities’ ability to 

withstand adversity, strengthening 

health and response systems, and 

enhancing national health security. To 

learn more about ASPR and 

preparedness, response, and recovery 

from the health impacts of disasters, 

visit the HHS public health and medical 

emergency Web site, www.phe.gov. 

Dated: September 13, 2013. 

Nicole Lurie, 

Assistant Secretary for Preparedness and 

Response. 

[FR Doc. 2013–22854 Filed 9–19–13; 8:45 am] 

BILLING CODE 4150–37–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–3287–PN] 

Medicare and Medicaid Programs; 

Application from the Compliance Team 

for Initial CMS-Approval of its Rural 

Health Clinic 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 Compliance Team 

for initial recognition as a national 

accrediting organization for rural health 

clinics (RHCs) 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 October 21, 2013. 

ADDRESSES: In commenting, please refer 

to file code CMS–3287–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 http://

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–3287– 

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–3287–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: Lisa 

Sullivan, (410) 786–2841; Cindy 

Melanson, (410) 786–0310; or 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–3287–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: http://

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 a Rural Health Clinic 

(RHC) provided certain requirements are 

met. Section 1861(aa), and 1905(l)(1) of 

the Social Security Act (the Act), 

establishes distinct criteria for facilities 

seeking designation as an RHC. 

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, subpart A. The 

regulations at 42 CFR part 491, subpart 

A specify the minimum conditions that 

a RHC must meet to participate in the 

Medicare program. The conditions for 

Medicare payment for RHCs are set forth 

at 42 CFR 405, subpart X. 

Generally, to enter into an agreement, 

a RHC must first be certified by a state 

survey agency as complying with the 

conditions or requirements set forth in 

part 491 of our regulations. Thereafter, 

the RHC 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 surveys by state agencies. 

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 

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57858 Federal Register / Vol. 78, No. 183 / Friday, September 20, 2013 / Notices 

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. 

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 the 

Compliance Team’s request for initial 

CMS approval of its RHC accreditation 

program. This notice also solicits public 

comment on whether the Compliance 

Team’s requirements meet or exceed the 

Medicare conditions for certification for 

RHC. 

III. Evaluation of Deeming Authority 

Request 

The Compliance Team submitted all 

the necessary materials to enable us to 

make a determination concerning its 

request for initial approval of its RHC 

accreditation program. This application 

was determined to be complete on July 

26, 2013. 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 Compliance Team will 

be conducted in accordance with, but 

not necessarily limited to, the following 

factors: 

• The equivalency of the Compliance 

Team’s standards for RHC’s as 

compared with our RHC conditions for 

certification. 

• The Compliance Team’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 

Compliance Team’s processes to those 

of state agencies, including survey 

frequency, and the ability to investigate 

and respond appropriately to 

complaints against accredited facilities. 

++ The Compliance Team’s processes 

and procedures for monitoring a RHC 

found out of compliance with the 

Compliance Team’s program 

requirements. These monitoring 

procedures are used only when the 

Compliance Team 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 Compliance Team’s capacity to 

report deficiencies to the surveyed 

facilities and respond to the facility’s 

plan of correction in a timely manner. 

++ The Compliance Team’s capacity to 

provide us with electronic data and 

reports necessary for effective 

validation and assessment of the 

organization’s survey process. 

++ The adequacy of the Compliance 

Team’s staff and other resources, and 

its financial viability. 

++ The Compliance Team’s capacity to 

adequately fund required surveys. 

++ The Compliance Team’s policies 

with respect to whether surveys are 

announced or unannounced, to assure 

that surveys are unannounced. 

++ The Compliance Team’s agreement 

to provide us with a copy of the most 

current accreditation survey together 

with any other information related to 

the survey as we may require 

(including corrective action plans). 

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 

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: September 4, 2013. 

Marilyn Tavenner, 

Administrator, Centers for Medicare & 

Medicaid Services. 

[FR Doc. 2013–22849 Filed 9–19–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Tribal Consultation Meeting 

AGENCY: Administration for Children 

and Families’ Office of Head Start 

(OHS), HHS. 

ACTION: Notice of meeting. 

SUMMARY: Pursuant to the Improving 

Head Start for School Readiness Act of 

2007, Public Law 110–134, notice is 

hereby given of two 1-day Tribal 

Consultation Sessions to be held 

between the Department of Health and 

Human Services, Administration for 

Children and Families, Office of Head 

Start leadership and the leadership of 

Tribal Governments operating Head 

Start (including Early Head Start) 

programs. The purpose of these 

Consultation Sessions is to discuss ways 

to better meet the needs of American 

Indian and Alaska Native children and 

their families, taking into consideration 

funding allocations, distribution 

formulas, and other issues affecting the 

delivery of Head Start services in their 

geographic locations [42 U.S.C. 9835, 

640(l)(4)]. 

DATES: October 23, 2013, and October 

29, 2013. 

ADDRESSES: 2013 Office of Head Start 

Tribal Consultation Sessions will be 

held at the following locations: 

Wednesday, October 23, 2013— 

Fairbanks, Alaska—Fairbanks Princess 

Riverside Lodge, 4477 Pikes Landing 

Road, Fairbanks, AK 99709; and 

Tuesday, October 29, 2013—Rapid City, 

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