The Centers for Medicare & Medicaid Services today issued a final rule that cancels the cardiac and surgical hip and femur fracture treatment mandatory bundling payment programs, known as the episode payment models. It also cancels the cardiac rehabilitation incentive payment model. These programs had been scheduled to begin Jan. 1, 2018. The rule also finalizes revisions to certain aspects of the Comprehensive Care for Joint Replacement model, including giving certain hospitals selected for participation in the CJR model a one-time option to choose whether to continue their participation in the model. Specifically, the CJR model will continue on a mandatory basis in 34 of the 67 selected geographic areas, with an exception for low-volume and rural hospitals, and continue on a voluntary basis in the other 33 of 67 areas. AHA had generally supported these changes. In addition, AHA Executive Vice President Tom Nickels said, “We are pleased that CMS has signaled that it will soon announce new voluntary payment bundles that will qualify as advanced alternative payment models. Doing so will allow hospitals to not only capitalize on the work many of them already have done to prepare for such models, but also partner with clinicians to provide better, more efficient care.” The rule also implements a policy to provide some flexibility in the determination of episode costs for CJR hospitals located in areas impacted by extreme and uncontrollable circumstances, such as the recent hurricanes.