Treatment of accreditation

Official source

(A) In general

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Treatment of accreditation

Official source

(A) In general

(A)

In general

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The Secretary shall provide that a Medicare+Choice organization is deemed to meet all the requirements described in any specific clause of subparagraph (B) if the organization is accredited (and periodically reaccredited) by a private accrediting organization under a process that the Secretary has determined assures that the accrediting organization applies and enforces standards that meet or exceed the standards established under section 1395w–26 of this title to carry out the requirements in such clause.

(B)Requirements described#

The provisions described in this subparagraph are the following:

(i) Paragraphs (1) through (3) of this subsection (relating to quality improvement programs).

(ii) Subsection (b) (relating to antidiscrimination).

(iii) Subsection (d) (relating to access to services).

(iv) Subsection (h) (relating to confidentiality and accuracy of enrollee records).

(v) Subsection (i) (relating to information on advance directives).

(vi) Subsection (j) (relating to provider participation rules).

(vii) The requirements described in section 1395w–104(j) of this title , to the extent such requirements apply under section 1395w–131(c) of this title .

(B)(i)#

Paragraphs (1) through (3) of this subsection (relating to quality improvement programs).

(B)(ii)#

Subsection (b) (relating to antidiscrimination).

(B)(iii)#

Subsection (d) (relating to access to services).

(B)(iv)#

Subsection (h) (relating to confidentiality and accuracy of enrollee records).

(B)(v)#

Subsection (i) (relating to information on advance directives).

(B)(vi)#

Subsection (j) (relating to provider participation rules).

(B)(vii)#

The requirements described in section 1395w–104(j) of this title , to the extent such requirements apply under section 1395w–131(c) of this title .

(C)Timely action on applications#

The Secretary shall determine, within 210 days after the date the Secretary receives an application by a private accrediting organization and using the criteria specified in section 1395bb(a)(2) of this title , whether the process of the private accrediting organization meets the requirements with respect to any specific clause in subparagraph (B) with respect to which the application is made. The Secretary may not deny such an application on the basis that it seeks to meet the requirements with respect to only one, or more than one, such specific clause.

(D)Construction#

Nothing in this paragraph shall be construed as limiting the authority of the Secretary under section 1395w–27 of this title , including the authority to terminate contracts with Medicare+Choice organizations under subsection (c)(2) of such section.