CMS Delays Expanded CJR Bundles for the Second Time and the Start of the Cardiac Bundles

Posted on Thursday, March 23, 2017 12:57 PM

According to an interim final rule posted to the Federal Register, CMS has delayed the expansion of a major bundled payment pilot, Comprehensive Care for Joint Replacement, and the implementation of its bundled payment initiatives for cardiac care from July 1 to October 1, 2017. CMS also delayed the effective date of a final rule for a second time, which outlines the implementation of CJR and other bundled payment programs, from March 21 to May 20, 2017.

“This additional 3-month delay is necessary to allow time for additional review, to ensure that the agency has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are warranted, and to ensure that in such a case participants have a clear understanding of the governing rules and are not required to take needless compliance steps,” the interim rule said.

The interim rule noted that the delay would allow participants more time to prepare for these models and the payment periods would actually align with the calendar year.

In addition, the CMS said, it is seeking comment on the possibility of delaying the start of cardiac bundles until January 1, 2018. If it pushes the cardiac bundles to a later date, it would also delay the CJR expansion to the same date, it added.

The CJR program was scheduled to develop in July to include repairing hip and femur fractures along with cardiac care.

The cardiac bundles were set to begin in July and end December 31, 2021.

CMS needs comment on “the appropriateness of this delay,” for 30 days after the interim final rule is filed for public inspection (March 21) in the Federal Register.

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