Rule Finalizes Cancellation of Episode Payment Models, Modifies CJR Model

Posted on December 07, 2017

The Centers for Medicare & Medicaid Services (CMS) recently released a final rule to cancel the Episode Payment Models (EPMs) and the Cardiac Rehabilitation (CR) Incentive Models that were proposed to begin Jan. 1, 2018. The rule also implements changes to the Comprehensive Care for Joint Replacement (CJR) bundled payment model, making CJR participation voluntary for eligible hospitals in 33 of the 67 Metropolitan Statistical Areas (MSAs), including hospitals in Flint and Saginaw. The CMS also released a fact sheet on the final rule.

Participation in the CJR model will terminate Dec. 31, 2017, for hospitals located in the voluntary MSAs. Between Jan. 1 and Jan. 31, 2018, hospitals in these voluntary geographic areas can elect to participate in the CJR bundled payment, with the election effective Feb. 1, 2018, until the CJR model ends Dec. 31, 2020. The CMS has provided the Voluntary Participation Election Letter (VPEL) template for use by hospitals in the voluntary MSAs that wish to continue participation in the CJR model. One completed VPEL should be submitted for each hospital that is choosing to opt into the CJR model. The VPEL must be signed by the administrator, chief financial officer or CEO of the hospital and emailed to the CMS by Jan. 31, 2018.

Featured in Monday Report. Click to view the full edition. In addition, the rule finalizes several technical refinements and clarifications for certain CJR model payment, reconciliation and quality provisions, as well as a change to the criteria for the Affiliated Practitioner List that will allow additional clinicians to be eligible for the CJR Advanced Alternative Payment Model track. The MHA encourages hospitals in Flint and Saginaw to evaluate participation in the CJR.  Members with questions should contact Vickie Kunz at the MHA. 

Tags: EPM, CJR, episode payment models, Cardiac Rehabilitation Incentive Models

Posted in: Member News

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