[Federal Register Volume 64, Number 175 (Friday, September 10, 1999)]
[Notices]
[Pages 49198-49199]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-23625]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[HCFA-2059-PN]
RIN 0938-AJ69
Medicare and Medicaid Programs; Application of the Community
Health Accreditation Program, Incorporated (CHAP) for Continued
Approval of Deeming Authority for Home Health Agencies
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Proposed notice.
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SUMMARY: This notice announces the receipt of an application from the
Community Health Accreditation Program, Incorporated (CHAP) for
recognition as a national accreditation program for home health
agencies (HHAs) that wish to participate in the Medicare or Medicaid
programs. The Social Security Act requires that the Secretary publish a
notice identifying the national accreditation body making the request
for approval, describing the nature of the request, and providing a 30-
day public comment period.
DATES: Written comments will be considered if we receive them at the
appropriate address, as provided in ADDRESSES section, no later than 5
p.m. on October 12, 1999.
ADDRESSES: Mail written comments (one original and three copies) to the
following address: Health Care Financing Administration, Department of
Health and Human Services, Attention: HCFA-2059-PN, P.O. Box 9010,
Baltimore, Maryland 21244-9010.
If you prefer, you may deliver your written comments (one original
and three copies) to one of the following addresses:
Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW.,
Washington, D.C. 20201, or
Room C5-16-03, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
FOR FURTHER INFORMATION CONTACT: Joan C. Berry, (410) 786-7233.
SUPPLEMENTARY INFORMATION:
Comments
Because of staffing and resource limitations, we cannot accept
comments by facsimile (FAX) transmission. In commenting, please refer
to file code HCFA-2059-PN. Comments received timely will be available
for public inspection as they are received, generally beginning
approximately 3 weeks after publication of a document, in Room 445-G of
the Department's offices at 200 Independence Avenue, SW, Washington,
DC, on Monday through Friday of each week from 8:30 a.m. to 5 p.m.
(phone: (202) 690-7890).
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(o) and 1891 of the Social Security
Act (the Act)and part 484 of the Medicare regulations specify the
conditions that an HHA must meet in order to participate in the
Medicare program.
Regulations concerning provider agreements are at 42 CFR part 489
and those pertaining to the activities relating
[[Page 49199]]
to the survey and certification of facilities are at 42 CFR part 488.
Generally, in order to enter into an agreement, an HHA must first
be certified by the State survey agency as complying with the
conditions or standards set forth in the statute and part 484 of our
regulations. Then, the HHA is subject to regular surveys by a State
survey agency to determine whether it continues to meet the
requirements. There is an alternative, however, to surveys by State
agencies.
Section 1865(b)(1) of the Act permits ``accredited'' HHAs to be
exempt from routine surveys by State survey agencies to determine
compliance with Medicare conditions of participation. Section
1865(b)(1) of the Act provides that if the Secretary finds that
accreditation of a provider entity by a national accreditation body
demonstrates that all applicable conditions are met or exceeded, the
Secretary ``deems'' those requirements to be met by the HHA. Our
regulations concerning reapproval of accrediting organizations are set
forth at Secs. 488.4 and 488.8(d)(3). Section 488.8(d)(3) requires
reapplication at least every 6 years and permits the Secretary to
determine the required materials from those enumerated in Sec. 488.4,
and the deadline to reapply for continued approval of deeming
authority. The Community Health Accreditation Program, Incorporated
(CHAP) is a currently recognized accreditation organization for HHAs.
II. Approval of Deeming Organizations
Section 1865(b)(2) of the Act further requires that the Secretary's
findings concerning review of national accrediting organizations
consider, among other factors, the accreditation organization's
requirements for accreditation, its survey procedures, its ability to
provide adequate resources for conducting required surveys and ability
to supply information for use in enforcement activities, its monitoring
procedures for provider entities found out of compliance with the
conditions or requirements, and its ability to provide the Secretary
with necessary data for validation.
Section 1865(b)(3)(A) of the Act requires that the Secretary
publish, within 60 days of the receipt of an organization's complete
application, a notice that identifies the national accreditation body
making the request, describes the nature of the request, and provides
at least a 30-day public comment period. Subsequently, the Secretary
has 210 days from the receipt of the request to publish a finding of
approval or denial of the application.
The purpose of this notice is to notify the public of CHAP's
request for reapproval and continuation of its deeming authority on the
basis that the Secretary find that its separate accreditation programs
for HHAs meet or exceed the Medicare conditions. This notice also
solicits public comment on the ability of CHAP's requirements to meet
or exceed the Medicare conditions of participation for HHAs.
III. Evaluation of Deeming Request
On July 15, 1999, CHAP submitted all the necessary information
concerning its request to be reapproved as a deeming organizations for
HHAs to permit us to make a determination. Under section 1865(b)(2) of
the Act and our regulations at Sec. 488.8 (``Federal review of
accreditation organizations''), our review and evaluation of a national
accreditation organization will be conducted in accordance with, but
not necessarily limited to, the following factors:
The equivalency of CHAP's requirements for an HHA to our
comparable HHA conditions of participation.
CHAP's survey processes, to determine the following:
--The composition of the survey team, surveyor qualifications, and
CHAP's ability to provide continuing surveyor training.
--The comparability of its implemented processes to those of State
agencies, including survey frequency, and its ability to investigate
and respond appropriately to complaints against accredited facilities.
--Its procedures for monitoring HHAs found by CHAP to be out of
compliance with program requirements. (These procedures are used only
when CHAP identifies noncompliance. If noncompliance is identified
through validation reviews, the survey agency monitors corrections as
specified at Sec. 488.7(b)(2).)
--Its ability to report deficiencies to the surveyed facilities and
respond to the facility's plan of correction in a timely manner.
--The ability of CHAP to provide us with electronic data in ASCII
comparable code and any reports necessary for effective validation and
assessment of its survey processes.
--The adequacy of CHAP's staff and other resources, and its financial
viability.
--CHAP's ability to provide adequate funding for performing required
surveys.
--CHAP's policies with respect to whether surveys are announced or
unannounced.
--CHAP'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. 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.
Authority: Sec. 1865(b)(3)(A) of the Social Security Act (42 U.S.C.
1395bb(b)(3)(A))
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance)
Dated: September 1, 1999.
Michael M. Hash,
Deputy Administrator, Health Care Financing Administration.
[FR Doc. 99-23625 Filed 9-9-99; 8:45 am]
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