Federal Register / Vol. 72, No. 207 / Friday, October 26, 2007 / Notices 60855 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare and Medicaid 

Services 

[CMS–2277–PN] 

Medicare and Medicaid Programs; 

Application by The Joint Commission 

for Continued Deeming Authority for 

Home Health Agencies 

AGENCY: Centers for Medicare and 

Medicaid Services, HHS. 

ACTION: Proposed notice. 

SUMMARY: This proposed notice with 

comment period acknowledges the 

receipt of a deeming application from 

The Joint Commission for continued 

recognition as a national accrediting 

organization for home health agencies 

that wish to participate in the Medicare 

or Medicaid programs. Section 

1865(b)(3)(A) of the Social Security Act 

requires that within 60 days of receipt 

of an organization’s complete 

application, we 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 November 26, 2007. 

ADDRESSES: In commenting, please refer 

to file code CMS–2277–PN. Because of 

staff and resource limitations, we cannot 

accept comments by facsimile (FAX) 

transmission. 

You may submit comments in one of 

four ways (no duplicates, please): 

1. Electronically. You may submit 

electronic comments on specific issues 

in this regulation to http:// 

www.cms.hhs.gov/eRulemaking. Click 

on the link ‘‘Submit electronic 

comments on CMS regulations with an 

open comment period.’’ (Attachments 

should be in Microsoft Word, 

WordPerfect, or Excel; however, we 

prefer Microsoft Word.) 

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–2277–

PN, P.O. Box 8010, 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 (one 

original and two copies) to the following 

address ONLY: 

Centers for Medicare & Medicaid 

Services, Department of Health and 

Human Services, Attention: CMS–2277–

PN, Mail Stop C4–26–05, 7500 Security 

Boulevard, Baltimore, MD 21244–1850. 

4. By hand or courier. If you prefer, 

you may deliver (by hand or courier) 

your written comments (one original 

and two copies) before the close of the 

comment period to one of the following 

addresses. If you intend to deliver your 

comments to the Baltimore address, 

please call telephone number (410) 786–

9994 in advance to schedule your 

arrival with one of our staff members. 

Room 445–G, Hubert H. Humphrey 

Building, 200 Independence Avenue, 

SW., Washington, DC 20201; or 7500 

Security Boulevard, Baltimore, MD 

21244–1850. 

(Because access to the interior of the 

HHH 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 mailed to the addresses 

indicated as appropriate for hand or 

courier delivery may be delayed and 

received after the comment period. 

For information on viewing public 

comments, see the beginning of the 

SUPPLEMENTARY INFORMATION section. 

FOR FURTHER INFORMATION CONTACT: 

Cindy Melanson, (410) 786–0310. 

Patricia Chmielewski, (410) 786–6899. 

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. You can assist us 

by referencing the file code CMS–2277–

PN and the specific ‘‘issue identifier’’

that precedes the section on which you 

choose to comment. 

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.cms.hhs.gov/ 

eRulemaking. Click on the link 

‘‘Electronic Comments on CMS 

Regulations’’ 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 home health agency 

(HHA) provided certain requirements 

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

1891 of the Social Security Act (the Act) 

establish distinct criteria for facilities 

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 

are at 42 CFR part 488. The regulations 

at 42 CFR part 484 specify the 

conditions that an HHA must meet in 

order to participate in the Medicare 

program, the scope of covered services 

and the conditions for Medicare 

payment for home health care. 

Generally, in order 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 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. There is an 

alternative, however, to surveys by State 

agencies. 

Section 1865(b)(1) of the Act provides 

that, if a provider entity demonstrates 

through accreditation by an approved 

national accrediting organization that all 

applicable Medicare conditions are met 

or exceeded, we will deem those 

provider entities as having met the 

requirements. Accreditation by an 

accrediting organization is voluntary 

and is not required for Medicare 

participation. 

If an accrediting organization is 

recognized by the Secretary as having 

standards for accreditation that meet or 

exceed Medicare requirements, any 

provider entity accredited by the 

national accrediting body’s approved 

program would be deemed to meet the 

Medicare conditions. A national 

accrediting organization applying for 

deeming authority 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 


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60856 Federal Register / Vol. 72, No. 207 / Friday, October 26, 2007 / Notices 

stringent as the Medicare conditions. 

Our regulations concerning the 

reapproval 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 deeming authority every six 

years or sooner as determined by us. 

The Joint Commission’s term of 

approval as a recognized accreditation 

program for HHAs expires March 31, 

2008. 

II. Approval of Deeming Organizations 

Section 1865(b)(2) of the Act and our 

regulations at § 488.8(a) require that our 

findings concerning review and 

reapproval 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(b)(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 

deeming authority for HHAs. This 

notice also solicits public comment on 

whether The Joint Commission’s 

requirements meet or exceed the 

Medicare conditions for participation 

for HHAs. 

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 reapproval as a deeming 

organization for HHAs. This application 

was determined to be complete on 

September 3, 2007. Under section 

1865(b)(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 standards for an HHA as 

compared with CMS’ HHA conditions of 

participation. 

• 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 HHAs 

found out of compliance with The 

Joint Commission program 

requirements. These monitoring 

procedures are used only when The 

Joint Commission identifies 

noncompliance. If noncompliance is 

identified through validation reviews, 

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 us with electronic data in 

ASCII comparable code, 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 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. Response to Public Comments and 

Notice Upon Completion of Evaluation 

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. 

V. 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). 

VI. Regulatory Impact Statement 

In accordance with the provisions of 

Executive Order 12866, the Office of 

Management and Budget did not review 

this proposed notice. 

In accordance with Executive Order 

13132, we have determined that this 

proposed notice would not have a 

significant effect on the rights of States, 

local or tribal governments. 

Authority: Section 1865 of the Social 

Security Act (42 U.S.C. 1395bb). 

(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: October 5, 2007. 

Kerry Weems, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. E7–20579 Filed 10–25–07; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–3181–FN] 

Medicare Program: Approval of 

Application by the American Diabetes 

Association (ADA) for Continued 

Recognition as a National 

Accreditation Organization That 

Accredits Entities To Furnish 

Outpatient Diabetes Self-Management 

Training 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final notice. 

SUMMARY: This final notice announces 

the approval of the American Diabetes 

Association (ADA) as a national 

accreditation organization for the 

purpose of determining that an entity 

meets the necessary quality standards to 

furnish outpatient diabetes selfmanagement training services under 

Part B of the Medicare program. 


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