[Federal Register: February 22, 2008 (Volume 73, Number 36)]
[Notices]
[Page 9811-9812]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr22fe08-79]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-3186-FN]
Medicare Program: Approval of Application by the Indian Health
Service (IHS) for Continued Recognition as a National Accreditation
Organization That Accredits American Indian and Alaska Native (AI/AN)
Entities To Furnish Outpatient Diabetes Self-Management Training
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final notice.
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SUMMARY: This final notice announces the approval of the Indian Health
Service (IHS) as a national accreditation organization for the purpose
of determining that entities meet the necessary quality standards to
furnish outpatient diabetes self-management training services under
Part B of the Medicare program. Therefore, American Indian and Alaska
Native diabetes self-management training (DSMT) programs accredited by
the IHS will receive
[[Page 9812]]
deemed status under the Medicare program for purposes of this benefit.
EFFECTIVE DATE: This approval of IHS as a national accreditation
organization is effective on February 22, 2008.
FOR FURTHER INFORMATION CONTACT: Eva Fung, (410) 786-7539.
SUPPLEMENTARY INFORMATION:
I. Background
To participate in the Medicare program, diabetes self-management
training (DSMT) programs must meet conditions for coverage specified in
our regulations at 42 CFR part 410, subpart H. One requirement is that
entities must satisfy required quality standards. An entity seeking
approval as a DSMT supplier must meet the requirements found at Sec.
410.144 as determined by an organization that meets the standards found
at Sec. 410.142. These organizations are referred to as national
accreditation organizations (NAOs).
II. Review Process
In evaluating an application from an accrediting organization, we
consider the following factors under section 1865(b)(2) of the Social
Security Act (the Act):
Accreditation requirements.
Survey procedures.
Ability to provide adequate resources for conducting
required surveys and to supply information for use in enforcement
activities.
Monitoring procedures.
Ability to provide us with the necessary data for
validation.
After the receipt of a written request to become a NAO or to renew
status as a NAO, a proposed notice is published in the Federal
Register, with a 30 day public comment period. After review of the
NAO's application, we are required to publish a final notice of
approval or denial no later than 210 days after the date of receipt of
a complete application package from the organization requesting to
become a NAO.
III. Analysis of and Responses to Public Comments
We received a complete application from the IHS on July 11, 2007.
On September 28, 2007, we published a proposed notice in the Federal
Register (72 FR 55222-55224) announcing the application from the IHS
for continued approval as a NAO for accrediting of American Indian (AI)
and Alaska Native (AN) entities that wish to furnish outpatient DSMT to
Medicare beneficiaries.
We note that no public comments were received on our proposed
notice.
IV. Provisions of the Final Notice
On March 22, 2002, we approved the IHS as a NAO for a term of 6
years to accredit AI/AN entities that provide diabetes self-management
training (67 FR 13345). We recognize that the IHS has a solid record of
experience in past decades in representing the interest of individuals
with diabetes. The AI/AN population has one of the highest rates of
diabetes in the world and the prevalence of diabetes is substantially
higher than in the general U.S. population. Recognizing the size of the
AI/AN population affected by diabetes, the Congress, since 1979, has
funded the IHS-administered National Diabetes Program to promote
collaborative strategies to combat diabetes, to develop standards-of-
care policies for diabetes, to disseminate comprehensive information
about diabetes, and to advocate for the AI/AN population. The IHS has
played a leadership role in the development of diabetic care
surveillance and data collection in the AI/AN diabetes programs. It
monitors the quality of the AI/AN diabetes education service through
its National Diabetes Program, IHS Area Consultants, the IHS Model
Diabetes Program, the Special Diabetes Grant Programs, and the IHS
Integrated Diabetes Education and Clinical Standards Recognition
Program for AI/AN communities. Additionally, the IHS works in
partnership with the IHS Model Diabetes Programs to tailor educational
materials, treatment programs, nutrition counseling, and physical
activities to accommodate cultural, physical, and geographical needs.
A special Task Force consisting of the American Diabetes
Association, the American Association of Diabetes Educators, the
American Dietetic Association, the Veteran's Health Service, the
National Certification Board for Diabetes Educators, the Centers for
Disease Control and Prevention, the Department of Veterans Affairs, the
Diabetes Research and Training Centers, the Indian Health Service, and
the National Certification Board for Diabetes Educators was convened on
March 31, 2006 and again on September 19, 2006 as part of the process
to update the National Standards for Diabetes Self-Management Education
Programs (NSDSMEP). The revised standards were approved on March 25,
2007 and were published in the June 2007 issue of Diabetes Care.
(Volume 30, Number 6.) Prior to revision, the Task Force reviewed the
standards for their appropriateness, relevancy, scientific basis,
specificity, and ability to be implemented in multiple settings. The
current NSDSMEP standards (7th Edition) were effectuated in June 2007
and reflect the changing approaches in diabetes training and education.
Our findings indicate that the IHS continues to meet our criteria
as ``a nonprofit organization with demonstrated experience in
representing the interests of individuals with diabetes'' to accredit
entities to furnish training as specified in Sec. 410.142(a) and
continues to meet all applicable requirements in Sec. 410.140 through
Sec. 410.146.
The Iowa Foundation for Medicare Care (IFMC) is under contract
(GS-35F-5831 H/HHSM 500-2006-0015IG) to CMS to validate the
DSMT accreditation policies of NAOs including IHS. IFMC surveyed a
sample of IHS accredited facilities. Based on these reviews, we have
determined that the IHS deeming authority has been exercised in
compliance with published requirements and have approved IHS' continued
recognition as a NAO, effective for 6 years, beginning February 22,
2008.
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).
Authority: Sections 1865 of the Social Security Act (42 U.S.C.
1395bb).
(Catalog of Federal Domestic Program No. 93.773, Medicare-Hospital
Insurance Program; and No. 93.774, Medicare--Supplementary Medical
Insurance Program)
Dated: December 6, 2007.
Kerry Weems,
Acting Administrator, Centers for Medicare & Medicaid Services.8
[FR Doc. E8-2803 Filed 2-21-08; 8:45 am]
BILLING CODE 4120-01-P
