19290 Federal Register / Vol. 77, No. 62 / Friday, March 30, 2012 / Notices 

• A description of the organization’s 

procedures for responding to and 

investigating complaints against 

accredited organizations, including 

policies and procedures regarding 

coordination of these activities with 

appropriate licensing bodies and 

ombudsmen programs. 

• A description of the organization’s 

policies and procedures with respect to 

the withholding or removal of 

accreditation for failure to meet the 

accreditation organization’s standards or 

requirements, and other actions the 

organization takes in response to 

noncompliance with its standards and 

requirements. 

• A description of all types (for 

example, full, partial) and categories (for 

example, provisional, conditional, 

temporary) of accreditation offered by 

the organization, the duration of each 

type and category of accreditation and a 

statement identifying the types and 

categories that would serve as a basis for 

accreditation if CMS approves the 

accreditation organization. 

• A list of all currently accredited MA 

organizations and the type, category, 

and expiration date of the accreditation 

held by each of them. 

• A list of all full and partial 

accreditation surveys scheduled to be 

performed by the accreditation 

organization as requested by CMS. 

• The name and address of each 

person with an ownership or control 

interest in the accreditation 

organization. 

• We will also consider URAC’s past 

performance in the deeming program 

and results of recent deeming validation 

reviews, or look-behind audits 

conducted as part of continuing Federal 

oversight of the deeming program under 

§ 422.157(d). 

B. Notice Upon Completion of 

Evaluation 

Upon completion of our evaluation, 

including evaluation of comments 

received as a result of this notice, we 

will publish a notice in the Federal 

Register announcing the result of our 

evaluation. 

Section 1852(e)(4)(C) of the Act 

provides a statutory timetable to ensure 

that our review of deeming applications 

is conducted in a timely manner. The 

Act provides us with 210 calendar days 

after the date of receipt of an application 

to complete our survey activities and 

application review process. At the end 

of the 210 day period, we must publish 

an approval or denial of the application 

in the Federal Register. 

III. 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. 

IV. Response to 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. 

Authority: Section 1865 of the Social 

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

(Catalog of Federal Domestic Assistance 

Program No. 93.773 Medicare—Hospital 

Insurance Program; and No. 93.774, 

Medicare-Supplementary Medical Insurance 

Program) 

Dated: March 23, 2012. 

Marilyn Tavenner, 

Acting CMS Administrator, Centers for 

Medicare & Medicaid Services. 

[FR Doc. 2012–7699 Filed 3–29–12; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–4166–PN] 

Medicare and Medicaid Programs; 

Renewal of Deeming Authority of the 

Accreditation Association for 

Ambulatory Health Care, Inc. for 

Medicare Advantage Health 

Maintenance Organizations and Local 

Preferred Provider Organizations 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Proposed notice. 

SUMMARY: This notice announces our 

proposal to renew the Medicare 

Advantage ‘‘deeming authority’’ of the 

Accreditation Association for 

Ambulatory Health Care, Inc. (AAAHC) 

for Health Maintenance Organizations 

and Preferred Provider Organizations for 

a term of 6 years. This new term of 

approval would begin July 11, 2012, and 

end July 10, 2018. This notice 

announces a 30-day period for public 

comments on the renewal of the 

application. 

DATES: To be assured consideration, 

comments must be received at one of 

the addresses provided below, no later 

than 5 p.m. on April 30, 2012. 

ADDRESSES: In commenting, please refer 

to file code CMS–4166–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 

to http://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–4166–PN, P.O. Box 8016, 

Baltimore, MD 21244–8016. 

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–4166–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 before the close 

of the comment period to either of 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, 

please call telephone number (410) 786– 

0361 in advance to schedule your 

arrival with one of our staff members. 

mstockstill on DSK4VPTVN1PROD with NOTICES

Federal Register / Vol. 77, No. 62 / Friday, March 30, 2012 / Notices 19291 

Comments mailed to the addresses 

indicated as appropriate for hand or 

courier delivery may be delayed and 

received after the comment period. 

FOR FURTHER INFORMATION CONTACT: 

Caroline Baker, (410) 786–0116; or 

Edgar Gallardo, (410) 786–0361. 

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 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 accrediting 

organization 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 renew its 

‘‘deeming authority’’ for a subsequent 

approval period. 

The Accreditation Association for 

Ambulatory Health Care, Inc. (AAAHC) 

was approved as a CMS-approved 

accreditation organization for MA 

HMOs and PPOs on July 12, 2006, and 

that term will expire on July 11, 2012. 

On December 14, 2011, AAAHC 

submitted an application to renew its 

deeming authority. On that same date, 

AAAHC submitted materials requested 

from CMS which included updates and/ 

or changes to items set out in Federal 

regulations at § 422.158(a) that are 

prerequisites for receiving accreditation 

program approval by CMS, and which 

were furnished to CMS by AAAHC as a 

part of their renewal applications for 

HMOs and PPOs. 

II. Provisions of the Proposed Notice 

The purpose of this notice is to notify 

the public of the AAAHC’s request to 

renew its Medicare Advantage deeming 

authority for HMOs and PPOs. AAAHC 

submitted all the necessary materials 

(including its standards and monitoring 

protocol) to enable us to make a 

determination concerning its request for 

approval as an accreditation 

organization for CMS. This renewal 

application was determined to be 

complete on February 6, 2012. Under 

section 1852(e)(4) of the Act and our 

regulations at § 422.158 (Federal review 

of accrediting organizations), our review 

and evaluation of AAAHC will include, 

but not necessarily be limited to, the 

following components: 

A. Components of the Review Process 

• The types of MA plans that it would 

review as part of its accreditation 

process. 

• A detailed comparison of the 

organization’s accreditation 

requirements and standards with the 

Medicare requirements (for example, a 

crosswalk). 

• Detailed information about the 

organization’s survey process, including 

the following— 

++ Frequency of surveys and whether 

surveys are announced or unannounced. 

++ Copies of survey forms, and 

guidelines and instructions to 

surveyors. 

++ Descriptions of— 

—The survey review process and the 

accreditation status decision making 

process; 

—The procedures used to notify 

accredited MA organizations of 

deficiencies and to monitor the 

correction of those deficiencies; and 

—The procedures used to enforce 

compliance with accreditation 

requirements. 

• Detailed information about the 

individuals who perform surveys for the 

accreditation organization, including 

the following— 

++ The size and composition of 

accreditation survey teams for each type 

of plan reviewed as part of the 

accreditation process; 

++ The education and experience 

requirements surveyors must meet; 

++ The content and frequency of the 

in-service training provided to survey 

personnel; 

++ The evaluation systems used to 

monitor the performance of individual 

surveyors and survey teams; and 

++ The organization’s policies and 

practice with respect to the 

participation, in surveys or in the 

accreditation decision process by an 

individual who is professionally or 

financially affiliated with the entity 

being surveyed. 

• A description of the organization’s 

data management and analysis system 

with respect to its surveys and 

accreditation decisions, including the 

kinds of reports, tables, and other 

displays generated by that system. 

• A description of the organization’s 

procedures for responding to and 

investigating complaints against 

accredited organizations, including 

policies and procedures regarding 

coordination of these activities with 

appropriate licensing bodies and 

ombudsmen programs. 

• A description of the organization’s 

policies and procedures with respect to 

mstockstill on DSK4VPTVN1PROD with NOTICES

19292 Federal Register / Vol. 77, No. 62 / Friday, March 30, 2012 / Notices 

the withholding or removal of 

accreditation for failure to meet the 

accreditation organization’s standards or 

requirements, and other actions the 

organization takes in response to 

noncompliance with its standards and 

requirements. 

• A description of all types (for 

example, full, partial) and categories (for 

example, provisional, conditional, 

temporary) of accreditation offered by 

the organization, the duration of each 

type and category of accreditation and a 

statement identifying the types and 

categories that would serve as a basis for 

accreditation if CMS approves the 

accreditation organization. 

• A list of all currently accredited MA 

organizations and the type, category, 

and expiration date of the accreditation 

held by each of them. 

• A list of all full and partial 

accreditation surveys scheduled to be 

performed by the accreditation 

organization as requested by CMS. 

• The name and address of each 

person with an ownership or control 

interest in the accreditation 

organization. 

• CMS will also consider AAAHC’s 

past performance in the deeming 

program and results of recent deeming 

validation reviews, or look-behind 

audits conducted as part of continuing 

Federal oversight of the deeming 

program under § 422.157(d). 

B. Notice Upon Completion of 

Evaluation 

Upon completion of our evaluation, 

including evaluation of comments 

received as a result of this notice, we 

will publish a notice in the Federal 

Register announcing the result of our 

evaluation. 

Section 1852(e)(4)(C) of the Act 

provides a statutory timetable to ensure 

that our review of deeming applications 

is conducted in a timely manner. The 

Act provides us with 210 calendar days 

after the date of receipt of an application 

to complete our survey activities and 

application review process. At the end 

of the 210 day period, we must publish 

an approval or denial of the application 

in the Federal Register. 

III. 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. 

IV. Response to 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. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773 Medicare-Hospital 

Insurance Program; and No. 93.774, 

Medicare-Supplementary Medical Insurance 

Program) 

Dated: March 23, 2012. 

Marilyn Tavenner, 

Acting CMS Administrator, Centers for 

Medicare & Medicaid Services. 

[FR Doc. 2012–7701 Filed 3–29–12; 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 

Title: Protection and Advocacy (P&A) 

Voting Access Annual Report. 

OMB No.: 0970–0326. 

Description: This is a revision of the 

annual report for the previously cleared 

Help America Vote Act (HAVA) Annual 

report. 

By Federal statute (the Help America 

Vote Act (HAVA) of 2002, Public Law 

107–252, Section 265(b), Reports, 42 

U.S.C. 15461) the governing agency is 

mandated to submit a report to the 

Committee on House Administration of 

the House of Representatives and the 

Committee on Rules and Administration 

of the Senate. As a result of the 

mandate, each State Protection & 

Advocacy (P&A) System receiving funds 

and activities carried out under HAVA 

Section 291 are requested to prepare an 

annual in accordance with the grant 

terms and conditions. The purpose of 

the annual report is to obtain 

information from each state/territory to 

use in the Congressional report 

submitted by the Secretary of the U.S. 

Department of Health and Human 

Services. 

Respondents: Protection & Advocacy 

Systems—All States, the District of 

Columbia, Puerto Rico, the U.S. Virgin 

Islands, American Samoa, and Guam. 

ANNUAL BURDEN ESTIMATES

Instrument Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden hours 

per response 

Total burden 

hours 

Protection and Advocacy (P&A) Voting Access Annual Report ...................... 55 1 20 1,100 

Estimated Total Annual Burden 

Hours: 1,100. 

Additional Information: Copies of the 

proposed collection may be obtained by 

writing to the Administration for 

Children and Families, Office of 

Planning, Research and Evaluation, 370 

L’Enfant Promenade SW., Washington, 

DC 20447, Attn: ACF Reports Clearance 

Officer. All requests should be 

identified by the title of the information 

collection. Email address: 

infocollection@acf.hhs.gov. 

OMB Comment: OMB is required to 

make a decision concerning 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. Written 

comments and recommendations for the 

proposed information collection should 

be sent directly to the following: Office 

of Management and Budget, Paperwork 

Reduction Project, Fax: 202–395–7285, 

Email: 

OIRA_SUBMISSION@OMB.EOP.GOV, 

Attn: Desk Officer for the 

Administration for Children and 

Families. 

Robert Sargis, 

Reports Clearance Officer. 

[FR Doc. 2012–7708 Filed 3–29–12; 8:45 am] 

BILLING CODE 4184–01–P 

mstockstill on DSK4VPTVN1PROD with NOTICES