Deemed Status and Surveys

40.2.1 - Deemed Status and Surveys (Rev. 117, Issued: 08-08-14, Effective: 08-08-14, Implementation: 08-08-14) 42 CFR §422.156(d) (1), (2) As noted in section 40.1 of this chapter, to be granted deemed status, an MAO must be accredited and periodically re-accredited by a CMS-approved AO. In addition, an MAO deemed to meet Medicare requirements must submit to surveys to validate its AO’s accreditation process. There are two types of validation surveys: 1. Observational (commonly referred to as concurrent); and 2. Retrospective (or look behind) surveys. An MAO that seeks deemed status must also agree to authorize its AO to release to CMS a copy of its most current accreditation survey, as well as any survey-related information that CMS may require (including CAPs and summaries of unmet CMS requirements). MAOs that are accredited by CMS-approved AOs are still subject to CMS surveys. As noted, an approved accrediting organization may only deem an MAO for one or more of the nine areas described in section 40.1 of this chapter. If the AO only has deeming authority in one of the nine2 deemable areas, such as access to services, then CMS may conduct a survey to assess the other 8 areas, as well as non-deemable requirements such as grievances and appeals, beneficiary disclosure, marketing, enrollment, and organization determinations. CMS always retains the authority to investigate complaints about an MAO.