Bundled Payment Program Expansion Delayed 3 Months by CMS

On Tuesday March 21, 2017, the Federal Register will publish an interim final rule delaying the effective dates of a final rule regarding bundled payment programs published January 3, 2017 titled “Medicare Program; Advancing Care Coordination Through Episode Payment Models; Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model”, which implemented three new Medicare Parts A and B episode payment models (“EPM”), the Cardiac Rehabilitation Incentive Payment Model (“CRIPM”), and modified the existing Comprehensive Care for Joint Replacement model (“CCJRM”). The interim final rule delays regulations scheduled to be effective March 21, 2017 to be effective May 20, 2017; and delays regulations scheduled to be effective July 1, 2017 to be effective October 1, 2017.

The new EPMs will select acute care hospitals in certain geographic areas to participate in retrospective EPMs for Medicare fee-for-service beneficiaries who received services during acute myocardial infarction, coronary bypass graft, and surgical hip/femur fracture treatment episodes; included in the episode of care is all related care within 90 days of hospital discharge. The CRIPM selects acute care hospitals in certain geographic areas to receive retrospective incentive payments for beneficiary utilization of cardiac rehabilitation/intensive cardiac rehabilitation services during the 90 days following discharge from a hospitalization treatment of an acute myocardial infarction or coronary artery bypass graft surgery.

January 3, 2017 Final Rule 

Unpublished March 21, 2017 Interim Final Rule 

CCJRM Frequently Asked Questions