CMS Releases CJR Model Three Year Extension and Changes Proposed Rule

On February 20, 2020 the Centers for Medicare & Medicaid Services (CMS) released Proposed Rule Comprehensive Care for Joint Replacement (CJR) Model Three Year Extension and Changes to Episode Definition and Pricing (CMS 5529 P). The Proposed Rule would extend the CJR to December 31, 2023 for Performance Years 6-8. It would also expand the model to include outpatient THA and TKA beginning in 2021, as well as adjusting target pricing and include some risk adjustment at reconciliation. The Rule proposes to eliminate the 50% cap on gainsharing payments, distribution payments, and downstream distribution payments when the recipient of these payments is a physician, non-physician practitioner, physician group practice, or non-physician practitioner group practice. Read our summary for more information. AAHKS will be submitting comments to CMS and will share those as well.