---
kind: "section"
citation: "42 C.F.R. § 422.156"
title: "42"
number: "422.156"
heading: "Compliance deemed on the basis of accreditation."
url: "https://uscodex.org/cfr/42/422.156"
---

# §422.156. Compliance deemed on the basis of accreditation.

- (a) **General rule.** An MA organization is deemed to meet all of the requirements of any of the areas described in [paragraph (b)](#b) of this section if—
  - (1) The MA organization is fully accredited (and periodically reaccredited) for the standards related to the applicable area under [paragraph (b)](#b) of this section by a private, national accreditation organization approved by CMS; and
  - (2) The accreditation organization used the standards approved by CMS for the purposes of assessing the MA organization's compliance with Medicare requirements.
- (b) **Deemable requirements.** The requirements relating to the following areas are deemable:
  - (1) **Quality improvement.** The deeming process should focus on evaluating and assessing the overall quality improvement (QI) program. However, the chronic care improvement programs (CCIPs) will be excluded from the deeming process.
  - (2) **Antidiscrimination.**
  - (3) **Access to services.**
  - (4) **Confidentiality and accuracy of enrollee records.**
  - (5) **Information on advance directives.**
  - (6) **Provider participation rules.**
  - (7) The requirements listed in [§ 423.165 (b)(1) through (3)](/cfr/42/423.165.md?p=b-1..b-3) of this chapter for MA organizations that offer prescription drug benefit programs.
- (c) **Effective date of deemed status.** The date on which the organization is deemed to meet the applicable requirements is the later of the following:
  - (1) **The date on which the accreditation organization is approved by CMS.**
  - (2) **The date the MA organization is accredited by the accreditation organization.**
- (d) **Obligations of deemed MA organizations.** An MA organization deemed to meet Medicare requirements must—
  - (1) Submit to surveys by CMS to validate its accreditation organization's accreditation process; and
  - (2) Authorize its accreditation organization to release to CMS a copy of its most recent accreditation survey, together with any survey-related information that CMS may require (including corrective action plans and summaries of unmet CMS requirements).
- (e) **Removal of deemed status.** CMS removes part or all of an MA organization's deemed status for any of the following reasons:
  - (1) CMS determines, on the basis of its own investigation, that the MA organization does not meet the Medicare requirements for which deemed status was granted.
  - (2) **CMS withdraws its approval of the accreditation organization that accredited the MA organization.**
  - (3) **The MA organization fails to meet the requirements of paragraph (d) of this section.**
- (f) **Authority.** Nothing in this subpart limits CMS' authority under subparts K and O of this part, including but not limited to, the ability to impose intermediate sanctions, civil money penalties, and terminate a contract with an MA organization.

## Notes

### Amendments

[63 FR 35082, June 26, 1998, as amended at 65 FR 40323, June 29, 2000; 65 FR 59749, Oct. 6, 2000; 70 FR 4724, Jan. 28, 2005; 75 FR 19806, Apr. 15, 2010; 76 FR 21564, Apr. 15, 2011; 84 FR 15829, Apr. 16, 2019]

### Source

Source: 63 FR 35082, June 26, 1998, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302, 1306, 1395w-21 through 1395w-28, and 1395hh.

### Source

Source: 63 FR 18134, Apr. 14, 1998, unless otherwise noted.

### Amendments

[63 FR 35082, June 26, 1998, as amended at 65 FR 40323, June 29, 2000; 65 FR 59749, Oct. 6, 2000; 70 FR 4724, Jan. 28, 2005; 75 FR 19806, Apr. 15, 2010; 76 FR 21564, Apr. 15, 2011; 84 FR 15829, Apr. 16, 2019]