Deeming
The Balanced Budget Act of 1997 (BBA) and of the subsequent Balance Budget Refinement Act of 1999 (BBRA) gave CMS the authority to establish and oversee a program that allows private, national accreditation organizations to "deem" that a Medicare Advantage organization is compliant with certain Medicare requirements. Six areas are deemable: quality assurance, antidiscrimination, access to services, confidentiality and accuracy of enrollee records, information on advance directives, and provider participation rules. To be approved for deeming authority, an accrediting organization must demonstrate that their program meets or exceeds the Medicare requirements for which they are seeking the authority to deem compliance.
A Federal Register notice inviting national, private accreditation organizations to send a letter of interest to apply for deeming authority was issued on June 29, 2000. Several organizations have been sent a packet explaining application requirements. These requirements are now available on-line at this website.
Once applications are received, they will be reviewed for completeness. Once an application is determined to be complete, the BBRA specified that CMS has only 210 days to review the application and either grant or deny Medicare Advantage deeming approval. At the end of the 210-day clock, CMS will publish a notice in the Federal Register informing the public that the accrediting organization has been approved for Medicare Advantage deeming.
This site contains the following information:
-
Letter from
CMS in response to expressed interest in applying for
deeming authority
-
Checklist
showing information to be included in the deeming application
- Medicare Advantage Deeming Information
-
-
Medicare Advantage Deeming
Glossary
Last Modified on Thursday, September 16, 2004
Centers for Medicare & Medicaid Services