30588 Federal Register / Vol. 74, No. 122 / Friday, June 26, 2009 / 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 

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 

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 6 

years or sooner as determined by us. 

The American Association for 

Accreditation of Ambulatory Surgery 

Facilities (AAAASF) term of approval as 

a recognized accreditation program for 

ASCs expires November 26, 2009. 

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 

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(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 AAAASF’s 

request for continued deeming authority 

for ASCs. This notice also solicits public 

comment on whether AAAASF’s 

requirements meet or exceed the 

Medicare conditions for coverage for 

ASCs. 

III. Evaluation of Deeming Authority 

Request 

The AAAASF submitted all the 

necessary materials to enable us to 

determine its application to be complete 

on May 1, 2009. Under Section 

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

at § 488.8 (Federal review of 

accreditation organizations), our review 

and evaluation of AAAASF will be 

conducted in accordance with, but not 

necessarily limited to, the following 

factors: 

• The equivalency of AAAASF’s 

standards for an ASC as compared with 

CMS’ ASC conditions for coverage. 

• AAAASF’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 AAAASF’s 

processes to those of State agencies, 

including survey frequency, and the 

ability to investigate and respond 

appropriately to complaints against 

accredited facilities. 

—AAAASF’s processes and procedures 

for monitoring ASCs found out of 

compliance with AAAASF’s program 

requirements. These monitoring 

procedures are used only when 

AAAASF identifies noncompliance. If 

noncompliance is identified through 

validation reviews, the State survey 

agency monitors corrections as 

specified at § 488.7(d). 

—AAAASF’s capacity to report 

deficiencies to the surveyed facilities 

and respond to the facility’s plan of 

correction in a timely manner. 

—AAAASF’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 AAAASF’s staff and 

other resources, and its financial 

viability. 

—AAAASF’s capacity to adequately 

fund required surveys. 

—AAAASF’s policies with respect to 

whether surveys are announced or 

unannounced, to assure that surveys 

are unannounced. 

—AAAASF’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. 

V. 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. 93.778, Medical Assistance 

Program; No. 93.773 Medicare—Hospital 

Insurance Program; and No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: June 11, 2009. 

Charlene Frizzera, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. E9–15186 Filed 6–25–09; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–2302–PN] 

Medicare and Medicaid Programs; 

Application by the Joint Commission 

for Continued Deeming Authority for 

Hospitals 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

ACTION: Proposed notice. 

SUMMARY: This proposed notice 

acknowledges the receipt of a deeming 

application from the Joint Commission 

for continued recognition as a national 

accrediting organization for hospitals 

that wish to participate in the Medicare 

or Medicaid programs. The statute 

requires that we publish within 60 days 

of receipt of an organization’s complete 

application, 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 July 27, 2009. 

ADDRESSES: In commenting, please refer 

to file code CMS–2302–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 

Federal Register / Vol. 74, No. 122 / Friday, June 26, 2009 / Notices 30589 

the instructions under the ‘‘More Search 

Options’’ tab. 

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–2302–PN, P.O. Box 8010, 

Baltimore, MD 21244–1850. 

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–2302–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– 

9994 in advance to schedule your 

arrival with one of our staff members. 

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: 

Cindy Melanson, (410) 786–0310. 

Patricia Chmielewski, (410) 786–6899. 

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 from a hospital provided 

certain requirements are met. Section 

1861(e) of the Social Security Act (the 

Act) establishes distinct criteria for 

facilities seeking designation as a 

hospital. 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 482 specify 

the conditions that a hospital must meet 

in order to participate in the Medicare 

program, the scope of covered services 

and the conditions for Medicare 

payment for hospitals. 

Generally, in order to enter into a 

provider agreement with the Medicare 

program, a hospital must first be 

certified by a State survey agency as 

complying with the conditions or 

requirements set forth in part 482 of our 

regulations. Thereafter, the hospital 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(a)(1) of the Act (as redesignated under section 125 of the 

Medicare Improvements for Patients and 

Providers Act of 2008 (MIPPA) (Pub. L. 

110–275)) 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. (We note that section 125 

of MIPPA redesignated subsections (b) 

and (e) of subsection 1865 of the Act as 

(a) and (d), respectively.) 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 

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 6 

years or as we determine. 

Section 125 of MIPPA revoked the 

Joint Commission’s statutory deeming 

status for their hospital program and 

required the Joint Commission to apply 

to be recognized as a national 

accreditation body for hospitals, based 

on terms and conditions required by the 

Secretary. These terms and conditions 

are outlined under part 488, subpart A, 

as described above. Based on the 24- 

month transition period allowed by 

section 125 of MIPPA, the Joint 

Commission’s term of approval as a 

recognized accreditation program for 

hospitals expires July 15, 2010. 

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 

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(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 a notice 

of approval or denial of the application. 

The purpose of this proposed notice 

is to inform the public of the Joint 

30590 Federal Register / Vol. 74, No. 122 / Friday, June 26, 2009 / Notices 

Commission’s request for continued 

deeming authority for hospitals. This 

notice also solicits public comment on 

whether the Joint Commission’s 

requirements meet or exceed the 

Medicare conditions for participation 

for hospitals. 

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 hospitals. This 

application was determined to be 

complete on May 1, 2009. 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 Joint Commission will 

be conducted in accordance with, but 

not necessarily limited to, the following 

factors: 

• The equivalency of the Joint 

Commission’s standards for a hospital 

as compared with CMS’ hospital 

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 hospitals 

found out of compliance with the 

Joint Commission’s 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 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). 

(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 14, 2009. 

Charlene Frizzera, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. E9–15183 Filed 6–25–09; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

Eunice Kennedy Shriver National 

Institute of Child Health and Human 

Development; Notice of Closed 

Meeting 

Pursuant to section 10(d) of the 

Federal Advisory Committee Act, as 

amended (5 U.S.C. App.), notice is 

hereby given of the following meeting. 

The meeting will be closed to the 

public in accordance with the 

provisions set forth in sections 

552b(c)(4) and 552b(c)(6), Title 5 U.S.C., 

as amended. The grant applications and 

the discussions could disclose 

confidential trade secrets or commercial 

property such as patentable material, 

and personal information concerning 

individuals associated with the grant 

applications, the disclosure of which 

would constitute a clearly unwarranted 

invasion of personal privacy. 

Name of Committee: National Institute of 

Child Health and Human Development 

Special Emphasis Panel; Mechanisms of 

Practice-Induced Reaching Improvement 

after Stroke. 

Date: July 17, 2009. 

Time: 11:30 a.m. to 3:30 p.m. 

Agenda: To review and evaluate grant 

applications. 

Place: National Institutes of Health, 6100 

Executive Boulevard, Room 5B01, Rockville, 

MD 20852 (Telephone Conference Call). 

Contact Person: Peter Zelazowski, PhD, 

Scientific Review Officer, Division of 

Scientific Review, Eunice Kennedy Shriver 

National Institute of Child Health and 

Human Development, NIH, 6100 Executive 

Boulevard, Rm. 5B01, Bethesda, MD 20892– 

7510, 301–435–6902, 

peter.zelazowski@nih.gov. 

(Catalogue of Federal Domestic Assistance 

Program Nos. 93.864, Population Research; 

93.865, Research for Mothers and Children; 

93.929, Center for Medical Rehabilitation 

Research; 93.209, Contraception and 

Infertility Loan Repayment Program, National 

Institutes of Health, HHS) 

Dated: June 18, 2009. 

Jennifer Spaeth, 

Director, Office of Federal Advisory 

Committee Policy. 

[FR Doc. E9–15053 Filed 6–25–09; 8:45 am] 

BILLING CODE 4140–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

National Institute of Diabetes and 

Digestive and Kidney Diseases; 

Amended Notice of Meeting 

Notice is hereby given of a change in 

the meeting of the National Institute of 

Diabetes and Digestive and Kidney 

Diseases Special Emphasis Panel, June 

25, 2009, 6 p.m. to June 26, 2009, 5 

p.m., Embassy Suites, 1250 22nd Street 

NW., Washington, DC 20037 which was 

published in the Federal Register on 

May 27, 2009, 74 FR 25261. 

This meeting will be held on August 

3, 2009 from 8:30 a.m. until 5 p.m. The 

meeting is closed to the public.