CMS Delays Implementation and Expansion of Bundled Payment Programs

In March, the Centers for Medicare and Medicaid Services (CMS) issued an interim rule to delay the implementation of its bundled payment program for cardiac care, as well as for expansion of its Comprehensive Care for Joint Replacement (CJR) program. Bundled payments were to have been provided for the cardiac care models for patients who receive cardiac rehabilitation, suffer heart attacks or undergo heart surgery, and for the CJR programs for patients who undergo nonreplacement surgery following a hip fracture. In addition, the cardiac program included a provision to make updates to the CJR model, including “refinements” of the bundle’s skilled nursing facility waiver. Both were slated for demonstrations beginning July 1 and ending Dec. 31, 2021. Under the interim rule, the programs are scheduled to begin Jan. 1, 2018.

“This additional three-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,” reads the interim rule. This is the second time the rule’s effective date has been changed.