42 U.S.C. § 1395bb : US Code - Section 1395BB: Effect of accreditation

Search 42 U.S.C. § 1395bb : US Code - Section 1395BB: Effect of accreditation

(a) In general
Except as provided in subsection (b) (!1) of this section and the
second sentence of section 1395z of this title, if -
(1) an institution is accredited as a hospital by the Joint
Commission on Accreditation of Hospitals, and
(2)(A) such institution authorizes the Commission to release to
the Secretary upon his request (or such State agency as the
Secretary may designate) a copy of the most current accreditation
survey of such institution made by such Commission, together with
any other information directly related to the survey as the
Secretary may require (including corrective action plans),(!2)
(B) such Commission releases such a copy and any such
information to the Secretary,
then, such institution shall be deemed to meet the requirements of
the numbered paragraphs of section 1395x(e) of this title; except -

(3) paragraph (6) thereof, and
(4) any standard, promulgated by the Secretary pursuant to
paragraph (9) thereof, which is higher than the requirements
prescribed for accreditation by such Commission.
If such Commission, as a condition for accreditation of a hospital,
requires a utilization review plan (or imposes another requirement
which serves substantially the same purpose), requires a discharge
planning process (or imposes another requirement which serves
substantially the same purpose), or imposes a standard which the
Secretary determines is at least equivalent to the standard
promulgated by the Secretary as described in paragraph (4) of this
subsection, the Secretary is authorized to find that all
institutions so accredited by such Commission comply also with
clause (A) or (B) of section 1395x(e)(6) of this title or the
standard described in such paragraph (4), as the case may be.
(b) Accreditation by American Osteopathic Association or other
national accreditation body
(1) In addition, if the Secretary finds that accreditation of a
provider entity (as defined in paragraph (4)) by the American
Osteopathic Association or any other national accreditation body
demonstrates that all of the applicable conditions or requirements
of this subchapter (other than the requirements of section 1395m(j)
of this title or the conditions and requirements under section
1395rr(b) of this title) are met or exceeded -
(A) in the case of a provider entity not described in paragraph
(3)(B), the Secretary shall treat such entity as meeting those
conditions or requirements with respect to which the Secretary
made such finding; or
(B) in the case of a provider entity described in paragraph
(3)(B), the Secretary may treat such entity as meeting those
conditions or requirements with respect to which the Secretary
made such finding.
(2) In making such a finding, the Secretary shall consider, among
other factors with respect to a national accreditation body, its
requirements for accreditation, its survey procedures, its ability
to provide adequate resources for conducting required surveys and
supplying 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.
(3)(A) Except as provided in subparagraph (B), not later than 60
days after the date of receipt of a written request for a finding
under paragraph (1) (with any documentation necessary to make a
determination on the request), the Secretary shall publish a notice
identifying the national accreditation body making the request,
describing the nature of the request, and providing a period of at
least 30 days for the public to comment on the request. The
Secretary shall approve or deny a request for such a finding, and
shall publish notice of such approval or denial, not later than 210
days after the date of receipt of the request (with such
documentation). Such an approval shall be effective with respect to
accreditation determinations made on or after such effective date
(which may not be later than the date of publication of the
approval) as the Secretary specifies in the publication notice.
(B) The 210-day and 60-day deadlines specified in subparagraph
(A) shall not apply in the case of any request for a finding with
respect to accreditation of a provider entity to which the
conditions and requirements of sections 1395i-3 and 1395x(j) of
this title apply.
(4) For purposes of this section, the term "provider entity"
means a provider of services, supplier, facility, clinic, agency,
or laboratory.
(c) Disclosure of accreditation survey
The Secretary may not disclose any accreditation survey (other
than a survey with respect to a home health agency) made and
released to him by the Joint Commission on Accreditation of
Hospitals, the American Osteopathic Association, or any other
national accreditation body, of an entity accredited by such body,
except that the Secretary may disclose such a survey and
information related to such a survey to the extent such survey and
information relate to an enforcement action taken by the Secretary.
(d) Deficiencies
Notwithstanding any other provision of this subchapter, if the
Secretary finds that a provider entity has significant deficiencies
(as defined in regulations pertaining to health and safety), the
entity shall, after the date of notice of such finding to the
entity and for such period as may be prescribed in regulations, be
deemed not to meet the conditions or requirements the entity has
been treated as meeting pursuant to subsection (a) or (b)(1) of
this section.
(e) State or local accreditation
For provisions relating to validation surveys of entities that
are treated as meeting applicable conditions or requirements of
this subchapter pursuant to subsection (a) or (b)(1) of this
section, see section 1395aa(c) of this title.