Notice2026-06499
Medicare and Medicaid Programs: Application From the Accreditation Commission for Health Care Inc. (ACHC) for Continued Approval of Its Critical Access Hospital Accreditation Program
Primary source
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Published
April 3, 2026
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
This notice announces our decision to approve the Accreditation Commission for Health Care Inc. (ACHC) for continued recognition as a national accrediting organization for critical access hospitals that wish to participate in the Medicare or Medicaid programs.
Full Text
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<title>Federal Register, Volume 91 Issue 64 (Friday, April 3, 2026)</title>
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[Federal Register Volume 91, Number 64 (Friday, April 3, 2026)]
[Notices]
[Pages 16946-16947]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-06499]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-3475-FN]
Medicare and Medicaid Programs: Application From the
Accreditation Commission for Health Care Inc. (ACHC) for Continued
Approval of Its Critical Access Hospital Accreditation Program
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice announces our decision to approve the
Accreditation Commission for Health Care Inc. (ACHC) for continued
recognition as a national accrediting organization for critical access
hospitals that wish to participate in the Medicare or Medicaid
programs.
DATES: The decision announced in this notice is applicable from
December 27, 2025, to December 27, 2031.
FOR FURTHER INFORMATION CONTACT:
Danielle Adams, (410) 786-8818.
Lillian Williams, (410) 786-8636.
SUPPLEMENTARY INFORMATION:
I. Background
Under the Medicare program, eligible beneficiaries may receive
covered services in a critical access hospital (CAH), provided that the
facility meets certain requirements. Sections 1820(c)(2)(B), 1820(e),
and 1861(mm)(1) of the Social Security Act (the Act) establish distinct
criteria for facilities seeking designation as a CAH. 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. Our regulations at 42 CFR part 485,
subpart F specify the conditions of participation (CoPs) that a CAH
must meet to participate in the Medicare program, the scope of covered
services, and the conditions for Medicare payment for CAHs. The
regulations at Sec. 485.647 specify that a CAH's psychiatric or
rehabilitation distinct part unit (DPU), if any, must meet the hospital
requirements specified in subparts A, B, C, and D of part 482 in order
for the CAH DPU to participate in the Medicare program.
Prior to becoming a CAH, to enter into an agreement, a CAH must
first be certified by a state survey agency as a hospital complying
with the conditions of participation at 42 CFR part 482. It then can
convert to a CAH by complying with the conditions or requirements at
part 485, subpart F. Thereafter, the CAH is subject to regular surveys
by a state survey agency to determine whether it continues to meet
these requirements. However, there is an alternative to surveys by
state agencies. Certification by a nationally recognized accreditation
program can substitute for ongoing state review.
Section 1865(a)(1) of the Act provides that, if a provider entity
demonstrates through accreditation by a Centers for Medicare & Medicaid
Services (CMS) approved national accrediting organization (AO) that all
applicable Medicare requirements are met or exceeded, we will deem
those provider entities as having met such requirements. Accreditation
by an AO is voluntary and is not required for Medicare participation.
If an AO is recognized by the Secretary of the Department of Health
and Human Services (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 requirements. A national AO
applying for approval of its accreditation program under 42 CFR part
488, subpart A, must provide CMS with reasonable assurance that the AO
requires the accredited provider entities to meet requirements that are
at least as stringent as the Medicare requirements.
Our regulations concerning the approval of AOs are at Sec. Sec.
488.4 and 488.5. The regulations at Sec. 488.5(e)(2)(i) require an AO
to reapply for continued approval of its accreditation program every 6
years or sooner, as determined by CMS. This notice is to announce our
continued approval of ACHC's CAH accreditation program for a period of
6 years.
II. Application Approval Process
Section 1865(a)(3)(A) of the Act provides a statutory timetable to
ensure that our review of applications for CMS-approval of an
accreditation program is conducted in a timely manner. The Act provides
us 210 days after the date of receipt of a complete application, with
any documentation necessary to make the determination, to complete our
survey activities and application process. Within 60 days after
receiving a complete application, we must publish a notice in the
Federal Register that identifies the national accrediting body making
the request, describes the request, and provides no less than a 30-day
public comment period. At the end of the 210-day period, we must
publish a notice in the Federal Register approving or denying the
application.
III. Provisions of the Proposed Notice
On July 23, 2025, we published a proposed notice in the Federal
Register (90 FR 34661), announcing ACHC's request for continued
approval of its Medicare critical hospital accreditation program. In
the proposed notice, we detailed our evaluation criteria. Under section
1865(a)(2) of the Act and in our regulations at Sec. 488.5, we
conducted a review of ACHC's Medicare CAH accreditation application in
accordance with the criteria specified by our regulations, which
include, but are not limited to, the following:
<bullet> An administrative review of ACHC's: (1) corporate
policies; (2) financial and human resources available to accomplish the
proposed surveys; (3) procedures for training, monitoring, and
evaluation of its surveyors; (4) ability to investigate and respond
appropriately to complaints against accredited facilities; and (5)
survey review and decision-making process for accreditation.
<bullet> A comparison of ACHC's accreditation to our current
Medicare CAH conditions of participation (CoPs).
<bullet> A documentation review of ACHC's survey process to:
++ Determine the composition of the survey team, surveyor
qualifications,
[[Page 16947]]
and ACHC's ability to provide continuing surveyor training.
++ Compare ACHC's processes to those of state survey agencies,
including survey frequency, and the ability to investigate and respond
appropriately to complaints against accredited facilities.
++ Evaluate ACHC's procedures for monitoring CAHs out of compliance
with ACHC's program requirements. The monitoring procedures are used
only when ACHC identifies noncompliance. If noncompliance is identified
through validation reviews, the state survey agency monitors
corrections as specified at Sec. 488.7(d).
++ Assess ACHC's ability to report deficiencies to the surveyed
facilities and respond to the facility's plan of correction in a timely
manner.
++ Establish ACHC's ability to provide CMS with electronic data and
reports necessary for effective validation and assessment of the
organization's survey process.
++ Determine the adequacy of staff and other resources.
++ Confirm ACHC's ability to provide adequate funding for
performing required surveys.
++ Confirm ACHC's policies with respect to whether surveys are
unannounced.
++ Obtain ACHC's agreement to provide CMS 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. Analysis of and Responses to Public Comments on the Proposed Notice
In accordance with section 1865(a)(3)(A) of the Act, the July 23,
2025 proposed notice also solicited public comments regarding whether
ACHC's requirements met or exceeded the Medicare CoPs for CAHs. We
received one comment in favor ACHC's CAH renewal application. We thank
the commenters for their input and have taken it into consideration
when making our decision.
V. Provisions of the Final Notice
A. Differences Between ACHC's Standards and Requirements for
Accreditation and Medicare Conditions and Survey Requirements
We compared ACHC's CAH requirements and survey process with the
Medicare CoPs and survey process as outlined in the State Operations
Manual (SOM). Our review and evaluation of ACHC's CAH application were
conducted as described in section III. of this notice and has yielded
the following areas where, as of the date of this notice, ACHC has
completed revising its standards and certification processes in order
to:
<bullet> Meet the standard's requirements of all of the following
regulations:
++ Section 485.623(c)(1)(i), revised standards to include a
reference to applicable Life Safety Code (LSC) section(s) in the
standards that did not include all of the applicable LSC requirements.
++ Section 485.623(d), revised standards to include a reference to
applicable Health Care Facility Code (HCFC) section(s) in the standards
that did not include all of the applicable HCFC requirements.
In addition to the standards review, we also reviewed ACHC's
comparable survey processes, which were conducted as described in
section III. of this notice, and yielded the following areas where, as
of the date of this notice, ACHC has completed revising its survey
processes, in order to demonstrate that it uses survey processes that
are comparable to state survey agency processes by:
<bullet> Revising ACHC's survey process documentation to include
both the 2012 editions of Life Safety Code (LSC) and Health Care
Facilities Code (HCFC), and 2013 edition of the Fire Safety Evaluation
System (FSES) NFPA 101A Fire Safety for Health Care Occupancies.
<bullet> Revising ACHC's survey process eligibility requirements
for organizations to also meet the 2012 HCFC (NFPA 99).
<bullet> Providing additional survey training to CAH surveyors on
citing levels as it relates to the initial comprehensive assessment,
for example, standard versus conditional level, to ensure compatibility
with Sec. 488.26(b).
B. Term of Approval
Based on our review and observations described in sections III. and
V. of this notice, we approve ACHC as a national AO for CAHs that
request participation in the Medicare program. The decision announced
in this final notice is effective December 27, 2025, through December
27, 2031.
VI. Collection of Information Requirements
This document does not impose information collection requirements,
that is, reporting, recordkeeping, or third party disclosure
requirements. Consequently, there is no need for review by the Office
of Management and Budget under the authority of the Paperwork Reduction
Act of 1995 (44 U.S.C. 3501 et seq.).
The Administrator of the Centers for Medicare & Medicaid Services
(CMS), Mehmet Oz, having reviewed and approved this document,
authorizes Vanessa Garcia, who is the Federal Register Liaison, to
electronically sign this document for purposes of publication in the
Federal Register.
Vanessa Garcia,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2026-06499 Filed 4-2-26; 8:45 am]
BILLING CODE 4120-01-P
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</html>Indexed from Federal Register on April 3, 2026.
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