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Subpart E--Accreditation by a Private, Nonprofit Accreditation Organization or Exemption Under an Approved State Laboratory Program

Section
493.551 General requirements for laboratories
493.553 Approval process (application and reapplication) for accreditation organizations and State licensure programs
493.555 Federal review of laboratory requirements
493.557 Additional submission requirements
493.559 Publication of approval of deeming authority or CLIA exemption
493.561 Denial of application or reapplication
493.563 Validation inspections--Basis and focus
493.565 Selection for validation inspection--laboratory responsibilities
493.567 Refusal to cooperate with validation inspection
493.569 Consequences of a finding of noncompliance as a result of a validation inspection
493.571 Disclosure of accreditation, State and CMS validation inspection results
493.573 Continuing Federal oversight of private nonprofit accreditation organizations and approved State licensure programs
493.575 Removal of deeming authority or CLIA exemption and final determination review
 
Subpart E--Accreditation by a Private, Nonprofit Accreditation 
Organization or Exemption Under an Approved State Laboratory Program

Source: 63 FR 26732, May 14, 1998, unless otherwise noted.

Sec. 493.551 General requirements for laboratories.

(a) Applicability. CMS may deem a laboratory to meet all applicable 
CLIA program requirements through accreditation by a private nonprofit 
accreditation program (that is, grant deemed status), or may exempt from 
CLIA program requirements all State licensed or approved laboratories in 
a State that has a State licensure program established by law, if the 
following conditions are met:
(1) The requirements of the accreditation organization or State 
licensure program are equal to, or more stringent than, the CLIA 
condition-level requirements specified in this part, and

[[Page 899]]

the laboratory would meet the condition-level requirements if it were 
inspected against these requirements.
(2) The accreditation program or the State licensure program meets 
the requirements of this subpart and is approved by CMS.
(3) The laboratory authorizes the approved accreditation 
organization or State licensure program to release to CMS all records 
and information required and permits inspections as outlined in this 
part.
(b) Meeting CLIA requirements by accreditation. A laboratory seeking 
to meet CLIA requirements through accreditation by an approved 
accreditation organization must do the following:
(1) Obtain a certificate of accreditation as required in subpart D 
of this part.
(2) Pay the applicable fees as required in subpart F of this part.
(3) Meet the proficiency testing (PT) requirements in subpart H of 
this part.
(4) Authorize its PT organization to furnish to its accreditation 
organization the results of the laboratory's participation in an 
approved PT program for the purpose of monitoring the laboratory's PT 
and for making the annual PT results, along with explanatory information 
required to interpret the PT results, available on a reasonable basis, 
upon request of any person. A laboratory that refuses to authorize 
release of its PT results is no longer deemed to meet the condition-
level requirements and is subject to a full review by CMS, in 
accordance with subpart Q of this part, and may be subject to the 
suspension or revocation of its certificate of accreditation under 
Sec. 493.1840.
(5) Authorize its accreditation organization to release to CMS or a 
CMS agent the laboratory's PT results that constitute unsuccessful 
participation in an approved PT program, in accordance with the 
definition of ``unsuccessful participation in an approved PT program,'' 
as specified in Sec. 493.2 of this part, when the laboratory has failed 
to achieve successful participation in an approved PT program.
(6) Authorize its accreditation organization to release to CMS a 
notification of the actions taken by the organization as a result of the 
unsuccessful participation in a PT program within 30 days of the 
initiation of the action. Based on this notification, CMS may take an 
adverse action against a laboratory that fails to participate 
successfully in an approved PT program.
(c) Withdrawal of laboratory accreditation. After an accreditation 
organization has withdrawn or revoked its accreditation of a laboratory, 
the laboratory retains its certificate of accreditation for 45 days 
after the laboratory receives notice of the withdrawal or revocation of 
the accreditation, or the effective date of any action taken by CMS, 
whichever is earlier.

Sec. 493.553 Approval process (application and reapplication) for 
accreditation organizations and State licensure programs.

(a) Information required. An accreditation organization that applies 
or reapplies to CMS for deeming authority, or a State licensure program 
that applies or reapplies to CMS for exemption from CLIA program 
requirements of licensed or approved laboratories within the State, must 
provide the following information:
(1) A detailed comparison of the individual accreditation, or 
licensure or approval requirements with the comparable condition-level 
requirements; that is, a crosswalk.
(2) A detailed description of the inspection process, including the 
following:
(i) Frequency of inspections.
(ii) Copies of inspection forms.
(iii) Instructions and guidelines.
(iv) A description of the review and decision-making process of 
inspections.
(v) A statement concerning whether inspections are announced or 
unannounced.
(vi) A description of the steps taken to monitor the correction of 
deficiencies.
(3) A description of the process for monitoring PT performance, 
including action to be taken in response to unsuccessful participation 
in a CMS-approved PT program.
(4) Procedures for responding to and for the investigation of 
complaints against its laboratories.
(5) A list of all its current laboratories and the expiration date 
of their

[[Page 900]]

accreditation or licensure, as applicable.
(6) Procedures for making PT information available (under State 
confidentiality and disclosure requirements, if applicable) including 
explanatory information required to interpret PT results, on a 
reasonable basis, upon request of any person.
(b) CMS action on an application or reapplication. If CMS receives 
an application or reapplication from an accreditation organization, or 
State licensure program, CMS takes the following actions:
(1) CMS determines if additional information is necessary to make a 
determination for approval or denial of the application and notifies the 
accreditation organization or State to afford it an opportunity to 
provide the additional information.
(2) CMS may visit the accreditation organization or State licensure 
program offices to review and verify the policies and procedures 
represented in its application and other information, including, but not 
limited to, review and examination of documents and interviews with 
staff.
(3) CMS notifies the accreditation organization or State licensure 
program indicating whether CMS approves or denies the request for 
deeming authority or exemption, respectively, and the rationale for any 
denial.
(c) Duration of approval. CMS approval may not exceed 6 years.
(d) Withdrawal of application. The accreditation organization or 
State licensure program may withdraw its application at any time before 
official notification, specified at Sec. 493.553(b)(3).

Sec. 493.555 Federal review of laboratory requirements.

CMS's review of an accreditation organization or State licensure 
program includes, but is not limited to, an evaluation of the following:
(a) Whether the organization's or State's requirements for 
laboratories are equal to, or more stringent than, the condition-level 
requirements for laboratories.
(b) The organization's or State's inspection process to determine 
the comparability of the full inspection and complaint inspection 
procedures and requirements to those of CMS, including, but not limited 
to, inspection frequency and the ability to investigate and respond to 
complaints against its laboratories.
(c) The organization's or State's agreement with CMS that requires 
it to do the following:
(1) Notify CMS within 30 days of the action taken, of any 
laboratory that has--
(i) Had its accreditation or licensure suspended, withdrawn, 
revoked, or limited;
(ii) In any way been sanctioned; or
(iii) Had any adverse action taken against it.
(2) Notify CMS within 10 days of any deficiency identified in an 
accredited or CLIA-exempt laboratory if the deficiency poses an 
immediate jeopardy to the laboratory's patients or a hazard to the 
general public.
(3) Notify CMS, within 30 days, of all newly--
(i) Accredited laboratories (or laboratories whose areas of 
specialty/subspecialty testing have changed); or
(ii) Licensed laboratories, including the specialty/subspecialty 
areas of testing.
(4) Notify each accredited or licensed laboratory within 10 days of 
CMS's withdrawal of the organization's deeming authority or State's 
exemption.
(5) Provide CMS with inspection schedules, as requested, for 
validation purposes.

Sec. 493.557 Additional submission requirements.

(a) Specific requirements for accreditation organizations. In 
addition to the information specified in Secs. 493.553 and 493.555, as 
part of the approval and review process, an accreditation organization 
applying or reapplying for deeming authority must also provide the 
following:
(1) The specialty or subspecialty areas for which the organization 
is requesting deeming authority and its mechanism for monitoring 
compliance with all requirements equivalent to condition-level 
requirements within the scope of the specialty or subspecialty areas.
(2) A description of the organization's data management and analysis 
system

[[Page 901]]

with respect to its inspection and accreditation decisions, including 
the kinds of routine reports and tables generated by the systems.
(3) Detailed information concerning the inspection process, 
including, but not limited to the following:
(i) The size and composition of individual accreditation inspection 
teams.
(ii) Qualifications, education, and experience requirements that 
inspectors must meet.
(iii) The content and frequency of training provided to inspection 
personnel, including the ability of the organization to provide 
continuing education and training to inspectors.
(4) Procedures for removal or withdrawal of accreditation status for 
laboratories that fail to meet the organization's standards.
(5) A proposed agreement between CMS and the accreditation 
organization with respect to the notification requirements specified in 
Sec. 493.555(c).
(6) Procedures for monitoring laboratories found to be out of 
compliance with its requirements. (These monitoring procedures must be 
used only when the accreditation organization identifies noncompliance. 
If noncompliance is identified through validation inspections, CMS or a 
CMS agent monitors corrections, as authorized at Sec. 493.565(d)).
(7) A demonstration of its ability to provide CMS with electronic 
data and reports in compatible code, including the crosswalk specified 
in Sec. 493.553(a)(1), that are necessary for effective validation and 
assessment of the organization's inspection process.
(8) A demonstration of its ability to provide CMS with electronic 
data, in compatible code, related to the adverse actions resulting from 
PT results constituting unsuccessful participation in PT programs as 
well as data related to the PT failures, within 30 days of the 
initiation of adverse action.
(9) A demonstration of its ability to provide CMS with electronic 
data, in compatible code, for all accredited laboratories, including the 
area of specialty or subspecialty.
(10) Information defining the adequacy of numbers of staff and other 
resources.
(11) Information defining the organization's ability to provide 
adequate funding for performing required inspections.
(12) Any facility-specific data, upon request by CMS, which 
includes, but is not limited to, the following:
(i) PT results that constitute unsuccessful participation in a CMS-
approved PT program.
(ii) Notification of the adverse actions or corrective actions 
imposed by the accreditation organization as a result of unsuccessful PT 
participation.
(13) An agreement to provide written notification to CMS at least 
30 days in advance of the effective date of any proposed change in its 
requirements.
(14) An agreement to disclose any laboratory's PT results upon 
reasonable request by any person.
(b) Specific requirements for a State licensure program. In addition 
to requirements in Secs. 493.553 and 493.555, as part of the approval 
and review process, when a State licensure program applies or reapplies 
for exemption from the CLIA program, the State must do the following:
(1) Demonstrate to CMS that it has enforcement authority and 
administrative structures and resources adequate to enforce its 
laboratory requirements.
(2) Permit CMS or a CMS agent to inspect laboratories in the 
State.
(3) Require laboratories in the State to submit to inspections by 
CMS or a CMS agent as a condition of licensure or approval.
(4) Agree to pay the cost of the validation program administered in 
that State as specified in Secs. 493.645(a) and 493.646(b).
(5) Take appropriate enforcement action against laboratories found 
by CMS not to be in compliance with requirements equivalent to CLIA 
requirements.
(6) Submit for Medicare and Medicaid payment purposes, a list of the 
specialties and subspecialties of tests performed by each laboratory.
(7) Submit a written presentation that demonstrates the agency's 
ability to furnish CMS with electronic data in compatible code, 
including the crosswalk specified in Sec. 493.553(a)(1).
(8) Submit a statement acknowledging that the State will notify CMS

[[Page 902]]

through electronic transmission of the following:
(i) Any laboratory that has had its licensure or approval revoked or 
withdrawn or has been in any way sanctioned by the State within 30 days 
of taking the action.
(ii) Changes in licensure or inspection requirements.
(iii) Changes in specialties or subspecialties under which any 
licensed laboratory in the State performs testing.
(9) Provide information for the review of the State's enforcement 
procedures for laboratories found to be out of compliance with the 
State's requirements.
(10) Submit information that demonstrates the ability of the State 
to provide CMS with the following:
(i) Electronic data and reports in compatible code with the adverse 
or corrective actions resulting from PT results that constitute 
unsuccessful participation in PT programs.
(ii) Other data that CMS determines are necessary for validation 
and assessment of the State's inspection process requirements.
(11) Agree to provide CMS with written notification of any changes 
in its licensure/approval and inspection requirements.
(12) Agree to disclose any laboratory's PT results in accordance 
with a State's confidentiality requirements.
(13) Agree to take the appropriate enforcement action against 
laboratories found by CMS not to be in compliance with requirements 
comparable to condition-level requirements and report these enforcement 
actions to CMS.
(14) If approved, reapply to CMS every 2 years to renew its exempt 
status and to renew its agreement to pay the cost of the CMS-
administered validation program in that State.

Sec. 493.559 Publication of approval of deeming authority or CLIA 
exemption.

(a) Notice of deeming authority or exemption. CMS publishes a 
notice in the Federal Register when it grants deeming authority to an 
accreditation organization or exemption to a State licensure program.
(b) Contents of notice. The notice includes the following:
(1) The name of the accreditation organization or State licensure 
program.
(2) For an accreditation organization:
(i) The specific specialty or subspecialty areas for which it is 
granted deeming authority.
(ii) A description of how the accreditation organization provides 
reasonable assurance to CMS that a laboratory accredited by the 
organization meets CLIA requirements equivalent to those in this part 
and would meet CLIA requirements if the laboratory had not been granted 
deemed status, but had been inspected against condition-level 
requirements.
(3) For a State licensure program, a description of how the 
laboratory requirements of the State are equal to, or more stringent 
than, those specified in this part.
(4) The basis for granting deeming authority or exemption.
(5) The term of approval, not to exceed 6 years.

Sec. 493.561 Denial of application or reapplication.

(a) Reconsideration of denial. (1) If CMS denies a request for 
approval, an accreditation organization or State licensure program may 
request, within 60 days of the notification of denial, that CMS 
reconsider its original application or application for renewal, in 
accordance with part 488, subpart D.
(2) If the accreditation organization or State licensure program 
requests a reconsideration of CMS's determination to deny its request 
for approval or reapproval, it may not submit a new application until 
CMS issues a final reconsideration determination.
(b) Resubmittal of a request for approval-- accreditation 
organization. An accreditation organization may resubmit a request for 
approval if a final reconsideration determination is not pending and the 
accreditation program meets the following conditions:
(1) It has revised its accreditation program to address the 
rationale for denial of its previous request.
(2) It demonstrates that it can provide reasonable assurance that 
its accredited facilities meet condition-level requirements.

[[Page 903]]

(3) It resubmits the application in its entirety.
(c) Resubmittal of request for approval--State licensure program. 
The State licensure program may resubmit a request for approval if a 
final reconsideration determination is not pending and it has taken the 
necessary action to address the rationale for any previous denial.

Sec. 493.563 Validation inspections--Basis and focus.

(a) Basis for validation inspection--(1) Laboratory with a 
certificate of accreditation. (i) CMS or a CMS agent may conduct an 
inspection of an accredited laboratory that has been issued a 
certificate of accreditation on a representative sample basis or in 
response to a substantial allegation of noncompliance.
(ii) CMS uses the results of these inspections to validate the 
accreditation organization's accreditation process.
(2) Laboratory in a State with an approved State licensure program. 
(i) CMS or a CMS agent may conduct an inspection of any laboratory in 
a State with an approved State licensure program on a representative 
sample basis or in response to a substantial allegation of 
noncompliance.
(ii) The results of these inspections are used to validate the 
appropriateness of the exemption of that State's licensed or approved 
laboratories from CLIA program requirements.
(b) Validation inspection conducted on a representative sample 
basis. (1) If CMS or a CMS agent conducts a validation inspection on a 
representative sample basis, the inspection is comprehensive, addressing 
all condition-level requirements, or it may be focused on a specific 
condition-level requirement.
(2) The number of laboratories sampled is sufficient to allow a 
reasonable estimate of the performance of the accreditation organization 
or State.
(c) Validation inspection conducted in response to a substantial 
allegation of noncompliance. (1) If CMS or a CMS agent conducts a 
validation inspection in response to a substantial allegation of 
noncompliance, the inspection focuses on any condition-level requirement 
that CMS determines to be related to the allegation.
(2) If CMS or a CMS agent substantiates a deficiency and 
determines that the laboratory is out of compliance with any condition-
level requirement, CMS or a CMS agent conducts a full CLIA inspection.
(d) Inspection of operations and offices. As part of the validation 
review process, CMS may conduct an onsite inspection of the operations 
and offices to verify the following:
(1) The accreditation organization's representations and to assess 
the accreditation organization's compliance with its own policies and 
procedures.
(2) The State's representations and to assess the State's compliance 
with its own policies and procedures, including verification of State 
enforcement actions taken on the basis of validation inspections 
performed by CMS or a CMS agent.
(e) Onsite inspection of an accreditation organization. An onsite 
inspection of an accreditation organization may include, but is not 
limited to, the following:
(1) A review of documents.
(2) An audit of meetings concerning the accreditation process.
(3) Evaluation of accreditation inspection results and the 
accreditation decision-making process.
(4) Interviews with the accreditation organization's staff.
(f) Onsite inspection of a State licensure program. An onsite 
inspection of a State licensure program office may include, but is not 
limited to, the following:
(1) A review of documents.
(2) An audit of meetings concerning the licensure or approval 
process.
(3) Evaluation of State inspection results and the licensure or 
approval decision-making process.
(4) Interviews with State employees.

Sec. 493.565 Selection for validation inspection--laboratory 
responsibilities.

A laboratory selected for a validation inspection must do the 
following:
(a) Authorize its accreditation organization or State licensure 
program, as applicable, to release to CMS or a CMS agent, on a 
confidential basis, a copy of the laboratory's most recent

[[Page 904]]

full, and any subsequent partial inspection.
(b) Authorize CMS or a CMS agent to conduct a validation 
inspection.
(c) Provide CMS or a CMS agent with access to all facilities, 
equipment, materials, records, and information that CMS or a CMS agent 
determines have a bearing on whether the laboratory is being operated in 
accordance with the requirements of this part, and permit CMS or a CMS 
agent to copy material or require the laboratory to submit material.
(d) If the laboratory possesses a valid certificate of 
accreditation, authorize CMS or a CMS agent to monitor the correction 
of any deficiencies found through the validation inspection.

Sec. 493.567 Refusal to cooperate with validation inspection.

(a) Laboratory with a certificate of accreditation. (1) A laboratory 
with a certificate of accreditation that refuses to cooperate with a 
validation inspection by failing to comply with the requirements in 
Sec. 493.565--
(i) Is subject to full review by CMS or a CMS agent, in accordance 
with this part; and
(ii) May be subject to suspension, revocation, or limitation of its 
certificate of accreditation under this part.
(2) A laboratory with a certificate of accreditation is again deemed 
to meet the condition-level requirements by virtue of its accreditation 
when the following conditions exist:
(i) The laboratory withdraws any prior refusal to authorize its 
accreditation organization to release a copy of the laboratory's current 
accreditation inspection, PT results, or notification of any adverse 
actions resulting from PT failure.
(ii) The laboratory withdraws any prior refusal to allow a 
validation inspection.
(iii) CMS finds that the laboratory meets all the condition-level 
requirements.
(b) CLIA-exempt laboratory. If a CLIA-exempt laboratory fails to 
comply with the requirements specified in Sec. 493.565, CMS notifies 
the State of the laboratory's failure to meet the requirements.

Sec. 493.569 Consequences of a finding of noncompliance as a result of 
a validation inspection.

(a) Laboratory with a certificate of accreditation. If a validation 
inspection results in a finding that the accredited laboratory is out of 
compliance with one or more condition-level requirements, the laboratory 
is subject to--
(1) The same requirements and survey and enforcement processes 
applied to laboratories that are not accredited and that are found out 
of compliance following an inspection under this part; and
(2) Full review by CMS, in accordance with this part; that is, the 
laboratory is subject to the principal and alternative sanctions in 
Sec. 493.1806.
(b) CLIA-exempt laboratory. If a validation inspection results in a 
finding that a CLIA-exempt laboratory is out of compliance with one or 
more condition-level requirements, CMS directs the State to take 
appropriate enforcement action.

Sec. 493.571 Disclosure of accreditation, State and CMS validation 
inspection results.

(a) Accreditation organization inspection results. CMS may disclose 
accreditation organization inspection results to the public only if the 
results are related to an enforcement action taken by the Secretary.
(b) State inspection results. Disclosure of State inspection results 
is the responsibility of the approved State licensure program, in 
accordance with State law.
(c) CMS validation inspection results. CMS may disclose the 
results of all validation inspections conducted by CMS or its agent.

Sec. 493.573 Continuing Federal oversight of private nonprofit 
accreditation organizations and approved State licensure 
programs.

(a) Comparability review. In addition to the initial review for 
determining equivalency of specified organization or State requirements 
to the comparable condition-level requirements, CMS reviews the 
equivalency of requirements in the following cases:
(1) When CMS promulgates new condition-level requirements.

[[Page 905]]

(2) When CMS identifies an accreditation organization or a State 
licensure program whose requirements are no longer equal to, or more 
stringent than, condition-level requirements.
(3) When an accreditation organization or State licensure program 
adopts new requirements.
(4) When an accreditation organization or State licensure program 
adopts changes to its inspection process, as required by 
Sec. 493.575(b)(1), as applicable.
(5) Every 6 years, or sooner if CMS determines an earlier review is 
required.
(b) Validation review. Following the end of a validation review 
period, CMS evaluates the validation inspection results for each 
approved accreditation organization and State licensure program.
(c) Reapplication procedures. (1) Every 6 years, or sooner, as 
determined by CMS, an approved accreditation organization must reapply 
for continued approval of deeming authority and a State licensure 
program must reapply for continued approval of a CLIA exemption. CMS 
provides notice of the materials that must be submitted as part of the 
reapplication procedure.
(2) An accreditation organization or State licensure program that 
does not meet the requirements of this subpart, as determined through a 
comparability or validation review, must furnish CMS, upon request, 
with the reapplication materials CMS requests. CMS establishes a 
deadline by which the materials must be submitted.
(d) Notice. (1) CMS provides written notice, as appropriate, to the 
following:
(i) An accreditation organization indicating that its approval may 
be in jeopardy if a comparability or validation review reveals that it 
is not meeting the requirements of this subpart and CMS is initiating a 
review of the accreditation organization's deeming authority.
(ii) A State licensure program indicating that its CLIA exemption 
may be in jeopardy if a comparability or validation review reveals that 
it is not meeting the requirements of this subpart and that a review is 
being initiated of the CLIA exemption of the State's laboratories.
(2) The notice contains the following information:
(i) A statement of the discrepancies that were found as well as 
other related documentation.
(ii) An explanation of CMS's review process on which the final 
determination is based and a description of the possible actions, as 
specified in Sec. 493.575, that CMS may impose based on the findings 
from the comparability or validation review.
(iii) A description of the procedures available if the accreditation 
organization or State licensure program, as applicable, desires an 
opportunity to explain or justify the findings made during the 
comparability or validation review.
(iv) The reapplication materials that the accreditation organization 
or State licensure program must submit and the deadline for that 
submission.

Sec. 493.575 Removal of deeming authority or CLIA exemption and final 
determination review.

(a) CMS review. CMS conducts a review of the following:
(1) A deeming authority review of an accreditation organization's 
program if the comparability or validation review produces findings, as 
described at Sec. 493.573. CMS reviews, as appropriate, the criteria 
described in Secs. 493.555 and 493.557(a) to reevaluate whether the 
accreditation organization continues to meet all these criteria.
(2) An exemption review of a State's licensure program if the 
comparability or validation review produces findings, as described at 
Sec. 493.573. CMS reviews, as appropriate, the criteria described in 
Secs. 493.555 and 493.557(b) to reevaluate whether the licensure program 
continues to meet all these criteria.
(3) A review of an accreditation organization or State licensure 
program, at CMS's discretion, if validation review findings, 
irrespective of the rate of disparity, indicate widespread or systematic 
problems in the organization's accreditation or State's licensure 
process that provide evidence that the requirements, taken as a whole, 
are no longer equivalent to CLIA requirements, taken as a whole.
(4) A review of the accreditation organization or State licensure 
program

[[Page 906]]

whenever validation inspection results indicate a rate of disparity of 
20 percent or more between the findings of the organization or State and 
those of CMS or a CMS agent for the following periods:
(i) One year for accreditation organizations.
(ii) Two years for State licensure programs.
(b) CMS action after review. Following the review, CMS may take 
the following action:
(1) If CMS determines that the accreditation organization or State 
has failed to adopt requirements equal to, or more stringent than, CLIA 
requirements, CMS may give a conditional approval for a probationary 
period of its deeming authority to an organization 30 days following the 
date of CMS's determination, or exempt status to a State within 30 days 
of CMS's determination, both not to exceed 1 year, to afford the 
organization or State an opportunity to adopt equal or more stringent 
requirements.
(2) If CMS determines that there are widespread or systematic 
problems in the organization's or State's inspection process, CMS may 
give conditional approval during a probationary period, not to exceed 1 
year, effective 30 days following the date of the determination.
(c) Final determination. CMS makes a final determination as to 
whether the organization or State continues to meet the criteria 
described in this subpart and issues a notice that includes the reasons 
for the determination to the organization or State within 60 days after 
the end of any probationary period. This determination is based on an 
evaluation of any of the following:
(1) The most recent validation inspection and review findings. To 
continue to be approved, the organization or State must meet the 
criteria of this subpart.
(2) Facility-specific data, as well as other related information.
(3) The organization's or State's inspection procedures, surveyors' 
qualifications, ongoing education, training, and composition of 
inspection teams.
(4) The organization's accreditation requirements, or the State's 
licensure or approval requirements.
(d) Date of withdrawal of approval. CMS may withdraw its approval 
of the accreditation organization or State licensure program, effective 
30 days from the date of written notice to the organization or State of 
this proposed action, if improvements acceptable to CMS have not been 
made during the probationary period.
(e) Continuation of validation inspections. The existence of any 
validation review, probationary status, or any other action, such as a 
deeming authority review, by CMS does not affect or limit the conduct 
of any validation inspection.
(f) Federal Register notice. CMS publishes a notice in the Federal 
Register containing a justification for removing the deeming authority 
from an accreditation organization, or the CLIA-exempt status of a State 
licensure program.
(g) Withdrawal of approval-effect on laboratory status--(1) 
Accredited laboratory. After CMS withdraws approval of an accreditation 
organization's deeming authority, the certificate of accreditation of 
each affected laboratory continues in effect for 60 days after it 
receives notification of the withdrawal of approval.
(2) CLIA-exempt laboratory. After CMS withdraws approval of a State 
licensure program, the exempt status of each licensed or approved 
laboratory in the State continues in effect for 60 days after a 
laboratory receives notification from the State of the withdrawal of 
CMS's approval of the program.
(3) Extension. After CMS withdraws approval of an accreditation 
organization or State licensure program, CMS may extend the period for 
an additional 60 days for a laboratory if it determines that the 
laboratory submitted an application for accreditation to an approved 
accreditation organization or an application for the appropriate 
certificate to CMS or a CMS agent before the initial 60-day period 
ends.
(h) Immediate jeopardy to patients. (1) If at any time CMS 
determines that the continued approval of deeming authority of any 
accreditation organization poses immediate jeopardy to the patients of 
the laboratories accredited

[[Page 907]]

by the organization, or continued approval otherwise constitutes a 
significant hazard to the public health, CMS may immediately withdraw 
the approval of deeming authority for that accreditation organization.
(2) If at any time CMS determines that the continued approval of a 
State licensure program poses immediate jeopardy to the patients of the 
laboratories in that State, or continued approval otherwise constitutes 
a significant hazard to the public health, CMS may immediately withdraw 
the approval of that State licensure program.
(i) Failure to pay fees. CMS withdraws the approval of a State 
licensure program if the State fails to pay the applicable fees, as 
specified in Secs. 493.645(a) and 493.646(b).
(j) State refusal to take enforcement action. (1) CMS may withdraw 
approval of a State licensure program if the State refuses to take 
enforcement action against a laboratory in that State when CMS 
determines it to be necessary.
(2) A laboratory that is in a State in which CMS has withdrawn 
program approval is subject to the same requirements and survey and 
enforcement processes that are applied to a laboratory that is not 
exempt from CLIA requirements.
(k) Request for reconsideration. Any accreditation organization or 
State that is dissatisfied with a determination to withdraw approval of 
its deeming authority or remove approval of its State licensure program, 
as applicable, may request that CMS reconsider the determination, in 
accordance with subpart D of part 488.

This page last reviewed: 7/7/2004
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