[Federal Register Volume 64, Number 175 (Friday, September 10, 1999)]
[Notices]
[Pages 49199-49201]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-23626]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[HCFA-2057-PN]
Medicare and Medicaid Programs; Reapplication of the American
Osteopathic Association (AOA) for Continued Approval of Deeming
Authority for Hospitals
AGENCY: Health Care Financing Administration (HCFA), HHS.
ACTION: Proposed notice.
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SUMMARY: This notice announces the receipt of a renewal application
from the American Osteopathic Association (AOA) for continued
recognition as a national accreditation program for hospitals that wish
to participate in the Medicare or Medicaid programs. Section
1865(b)(3)(A) of the Social Security Act (the Act) requires the
Secretary to publish a notice within 60 days of the receipt of an
organization's complete application, identifying the national
accreditation body making the request, 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 below, no later than 5 p.m. on October
12, 1999.
[[Page 49200]]
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-2057-PN, 7500 Security
Boulevard, Baltimore, Maryland 21244-1850.
If you prefer, you may deliver your written comments (one original
and three copies) to one of the following addresses:
Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW.,
Washington, DC 20201, or
Room C5-16-03, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Because of staffing and resource limitations, we cannot accept
audio, visual, or facsimile (FAX) copies of comments. In commenting,
please refer to file code HCFA-2057-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 443-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).
FOR FURTHER INFORMATION CONTACT: Janice Adams-King, (410) 786-8354.
SUPPLEMENTARY INFORMATION:
I. Background
Under the Medicare program, eligible beneficiaries may receive
covered services in a hospital provided certain requirements are met.
The regulations specifying the Medicare conditions of participation for
hospital care are located in 42 CFR part 482. These conditions
implement section 1861(e) of the Social Security Act (the Act), which
specifies services covered as hospital care and the conditions that a
hospital must meet in order to participate in the Medicare program.
Other relevant sections of the Act are section 1811, which specifies
eligibility requirements for the individual and the amount of benefits;
and sections 1814(l), 1876(h)(2), and 1886(c)(6) of the Act, which
contain conditions of payment for hospitals.
Regulations concerning provider agreements are at 42 CFR part 489
and those pertaining to the activities relating to the survey and
certification of facilities are at 42 CFR part 488. Our 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 hospital
services.
Generally, in order to enter into an agreement, a hospital must
first be certified by a State survey agency as complying with the
conditions or standards set forth in part 482 of our regulations. Then,
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(b)(1) of the Act permits ``accredited'' hospitals 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 a provider entity by a national
accreditation body demonstrates that all applicable conditions are met
or exceed the Medicare conditions, the Secretary can ``deem'' the
hospital as having met the requirements.
Our regulations concerning reapproval of accrediting organizations
are set forth at Secs. 488.4 and 488.8(d)(3). The regulations at
Sec. 488.8(d)(3) require reapplication at least every 6 years and
permit HCFA to determine the required materials from those enumerated
in Sec. 488.4, and the deadline to reapply for continued approval of
deeming authority.
This organization is currently a recognized accreditation
organization for hospitals.
II. Approval of Deeming Organizations
Section 1865(b)(2) of the Act further requires that the Secretary's
findings concerning review and reapproval of national accrediting
organizations consider, among other factors, the reapplying
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
reapplication, a notice identifying the national accreditation body
making the request, describing the nature of the request, and providing
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 reapplication.
The purpose of this notice is to notify the public of the request
of AOA for reapproval and continuation of its deeming authority on the
basis that the Secretary find that its separate accreditation programs
for hospital care meet or exceed the Medicare conditions. This notice
also solicits public comment on the ability of each body's requirements
to meet or exceed the Medicare conditions of participation.
III. Evaluation of Deeming Request
On ???1999, AOA submitted all the necessary information concerning
its request for reapproval as a deeming organization for hospitals 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 criteria:
The equivalency of AOA's requirements for a hospital to
HCFA's comparable hospital requirements.
AOA's survey process, to determine the following:
--The composition of the survey team, surveyor qualifications, and
AOA's ability to provide continuing surveyor training.
--The comparability of AOA's implemented process to those of State
agencies, including survey frequency, and its ability to investigate
and respond appropriately to complaints against accredited facilities;
--AOA's procedures for monitoring providers or suppliers found to be
out of compliance with AOA program requirements. (These procedures are
used only when AOA identifies noncompliance. If noncompliance is
identified through validation reviews, the survey agency monitors
corrections as specified at Sec. 488.7(b)(3).)
--AOA's ability to report deficiencies to the surveyed facilities and
respond to the facility's plan of correction in a timely manner.
The ability of AOA 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 AOA staff and other resources, and their
financial viability.
AOA's ability to provide adequate funding for performing
required surveys.
AOA's policies with respect to whether surveys are
announced or unannounced.
AOA's agreement to provide us with a copy of its most
current
[[Page 49201]]
accreditation survey with any other information related to the survey
as we may require (including corrective action plans).
IV. Response to Comments and Notice Upon Completion of Evaluation
Because of the large number of items of correspondence we normally
receive on Federal Register documents published for comment, 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.
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. 99-23626 Filed 9-9-99; 8:45 am]
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