31362 Federal Register / Vol. 77, No. 102 / Friday, May 25, 2012 / 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 

accrediting organizations to reapply for 

continued approval of its accreditation 

program every 6 years or sooner as 

determined by CMS. 

The American Osteopathic 

Association/Healthcare Facilities 

Accreditation Program’s (AOA/HFAP) 

current term of approval for their ASC 

accreditation program expires October 

23, 2012. 

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 AOA/HFAP’s 

request for continued approval of its 

ASC accreditation program. This notice 

also solicits public comment on whether 

AOA/HFPA’s requirements meet or 

exceed the Medicare conditions for 

coverage for ASCs. 

III. Evaluation of Deeming Authority 

Request 

AOA/HFAP 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 complete on 

March 27, 2012. Under Section 

1865(a)(2) of the Act and our regulations 

at § 488.8 (Federal review of accrediting 

organizations), our review and 

evaluation of AOA/HFAP will be 

conducted in accordance with, but not 

necessarily limited to, the following 

factors: 

• The equivalency of AOA/HFAP’s 

standards for an ASC as compared with 

CMS’ ASC conditions for coverage. 

• AOA/HFAP’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 AOA/HFAP’s 

processes to those of State agencies, 

including survey frequency, and the 

ability to investigate and respond 

appropriately to complaints against 

accredited facilities. 

• AOA/HFAP’s processes and 

procedures for monitoring an ASC 

found out of compliance with AOA/ 

HFAP’s program requirements. These 

monitoring procedures are used only 

when AOA/HFAP identifies 

noncompliance. If noncompliance is 

identified through validation reviews or 

complaint surveys, the State survey 

agency monitors corrections as specified 

at § 488.7(d). 

• AOA/HFAP’s capacity to report 

deficiencies to the surveyed facilities 

and respond to the facility’s plan of 

correction in a timely manner. 

• AOA/HFAP’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 AOA/HFAP’s staff 

and other resources, and its financial 

viability. 

• AOA/HFAP’s capacity to 

adequately fund required surveys. 

• AOA/HFAP’s policies with respect 

to whether surveys are announced or 

unannounced, to assure that surveys are 

unannounced. 

• AOA/HFAP’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). 

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—Ambulatory 

surgery center Insurance Program; and No. 

93.774, Medicare—Supplementary Medical 

Insurance Program) 

Dated: May 16, 2012. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2012–12823 Filed 5–24–12; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–3266–PN] 

Medicare and Medicaid Programs; 

Application From the Community 

Health Accreditation Program for 

Continued Approval of Its Hospice 

Accreditation Program 

AGENCY: Centers for Medicare and 

Medicaid Services, HHS. 

ACTION: Proposed notice. 

SUMMARY: This proposed notice with 

comment period acknowledges the 

receipt of an application from the 

Community Health Accreditation 

Program (CHAP) for continued 

recognition as a national accrediting 

organization for hospices 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 June 25, 2012. 

ADDRESSES: In commenting, refer to file 

code CMS–3266–PN. Because of staff 

and resource limitations, we cannot 

accept comments by facsimile (FAX) 

transmission. 

You may submit comments in one of 

four ways (please choose only one of the 

ways listed): 

1. Electronically. You may submit 

electronic comments on this regulation 

mstockstill on DSK4VPTVN1PROD with NOTICES

Federal Register / Vol. 77, No. 102 / Friday, May 25, 2012 / Notices 31363 

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–3266– 

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–3266–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 only 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.) 

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) 786–7195 in 

advance to schedule your arrival with 

one of our staff members. 

Comments erroneously 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: 

Lillian Williams, (410) 786–8636. 

Patricia Chmielewski, (410) 786–6899. 

Cindy Melanson, (410) 786–0310. 

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 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 in a hospice provided certain 

requirements are met. Section 1861(dd) 

(1) 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 to 

participate in the Medicare program, the 

scope of covered services, and the 

conditions for Medicare payment for 

hospice care. 

Generally, to enter into an agreement, 

a hospice must first be certified by a 

State survey agency as complying with 

the conditions or requirements set forth 

in part 418. Thereafter, the hospice 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 

provider entity accredited by the 

national accrediting body’s approved 

program will be deemed to have met 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 we 

determine. 

Community Health Accreditation 

Program (CHAP’s) current term of 

approval for their hospice accreditation 

program expires November 20, 2012. 

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 CHAP’s 

request for continued approval of its 

hospice accreditation program. This 

notice also solicits public comment on 

whether CHAP’s requirements meet or 

exceed the Medicare conditions for 

participation for hospices. 

III. Evaluation of Deeming Authority 

Request 

CHAP submitted all the necessary 

materials to enable us to make a 

determination concerning its request for 

continued approval of its hospice 

accreditation program. This application 

was determined to be complete on 

mstockstill on DSK4VPTVN1PROD with NOTICES

31364 Federal Register / Vol. 77, No. 102 / Friday, May 25, 2012 / Notices 

March 30, 2012. Under section 

1865(a)(2) of the Act and our regulations 

at § 488.8 (Federal review of accrediting 

organizations), our review and 

evaluation of CHAP will be conducted 

in accordance with, but not necessarily 

limited to, the following factors: 

• The equivalency of CHAP’s 

standards for a hospice as compared 

with CMS’ hospice conditions of 

participation. 

• CHAP’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 CHAP’s 

processes to those of State agencies, 

including survey frequency, and the 

ability to investigate and respond 

appropriately to complaints against 

accredited facilities. 

• CHAP’s processes and procedures 

for monitoring a hospice found out of 

compliance with CHAP’s program 

requirements. These monitoring 

procedures are used only when CHAP 

identifies noncompliance. If 

noncompliance is identified through 

validation reviews or complaint 

surveys, the State survey agency 

monitors corrections as specified at 

§ 488.7(d). 

• CHAP’s capacity to report 

deficiencies to the surveyed facilities 

and respond to the facility’s plan of 

correction in a timely manner. 

• CHAP’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 CHAP’s staff and 

other resources, and its financial 

viability. 

• CHAP’s capacity to adequately fund 

required surveys. 

• CHAP’s policies with respect to 

whether surveys are announced or 

unannounced, to assure that surveys are 

unannounced. 

• CHAP’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). 

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. 

V. Regulatory Impact Statement 

In accordance with the provisions of 

Executive Order 12866, this proposed 

notice was not reviewed by the Office of 

Management and Budget. 

(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: May 21, 2012. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2012–12816 Filed 5–24–12; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–4164–FN] 

Medicare Program; Approved Renewal 

of Deeming Authority of the Utilization 

Review Accreditation Commission for 

Medicare Advantage Health 

Maintenance Organizations and Local 

Preferred Provider Organizations 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Final notice. 

SUMMARY: This notice announces our 

decision to renew the Medicare 

Advantage ‘‘deeming authority’’ of the 

Utilization Review Accreditation 

Commission (URAC) for Health 

Maintenance Organizations and 

Preferred Provider Organizations for a 

term of 6 years. This new term of 

approval would begin May 26, 2012, 

and end May 25, 2018. 

DATES: This final notice is effective May 

26, 2012 through May 25, 2018. 

FOR FURTHER INFORMATION CONTACT: 

Caroline Baker, (410) 786–0116; or 

Edgar Gallardo, (410) 786–0361. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Under the Medicare program, eligible 

beneficiaries may receive covered 

services through a Medicare Advantage 

(MA) organization that contracts with 

CMS. The regulations specifying the 

Medicare requirements that must be met 

for a Medicare Advantage Organization 

(MAO) to enter into a contract with 

CMS are located at 42 CFR part 422. 

These regulations implement Part C of 

Title XVIII of the Social Security Act 

(the Act), which specifies the services 

that an MAO must provide and the 

requirements that the organization must 

meet to be an MA contractor. Other 

relevant sections of the Act are Parts A 

and B of Title XVIII and Part A of Title 

XI pertaining to the provision of 

services by Medicare-certified providers 

and suppliers. Generally, for an entity to 

be an MA organization, the organization 

must be licensed by the State as a 

riskbearing organization as set forth in 

part 422. 

As a method of assuring compliance 

with certain Medicare requirements, an 

MA organization may choose to become 

accredited by a CMS-approved 

accrediting organization (AO). Once 

accredited by such a CMS-approved AO, 

we deem the MA organization to be 

compliant in one or more of six 

requirements set forth in section 

1852(e)(4)(B) of the Act. For an AO to 

be able to ‘‘deem’’ an MA plan as 

compliant with these MA requirements, 

the AO must prove to CMS that its 

standards are at least as stringent as 

Medicare requirements. Health 

maintenance organizations (HMOs) or 

preferred provider organizations (PPOs) 

accredited by an approved AO may 

receive, at their request, ‘‘deemed’’ 

status for CMS requirements with 

respect to the following six MA criteria: 

Quality Improvement; 

Antidiscrimination; Access to Services; 

Confidentiality and Accuracy of 

Enrollee Records; Information on 

Advanced Directives; and Provider 

Participation Rules. (See 42 CFR 

422.156(b)). At this time, recognition of 

accreditation does not include the Part 

D areas of review set out at § 423.165(b). 

AOs that apply for MA deeming 

authority are generally recognized by 

the health care industry as entities that 

accredit HMOs and PPOs. As we specify 

at § 422.157(b)(2)(ii), the term for which 

an AO may be approved by CMS may 

not exceed 6 years. For continuing 

approval, the AO must apply to CMS to 

mstockstill on DSK4VPTVN1PROD with NOTICES