The Centers for Medicare & Medicaid Services today finalized without changes its “extreme and uncontrollable circumstances” policy for hospitals participating in the Comprehensive Care for Joint Replacement Payment Model. Like the November 2017 interim final rule, the final rule provides flexibility in determining episode spending for CJR hospitals located in areas impacted by a major disaster declaration under the Stafford Act for which the Health and Human Services Secretary has temporarily waived certain Medicare requirements under Section 1135 of the Social Security Act. For example, the policy last year applied to certain hospitals in areas impacted by hurricanes and wildfires. “The AHA is pleased that CMS recognizes the many unique challenges presented to hospitals and health systems on the front-lines of providing patient and community care following natural disasters and public health emergencies and is modifying the CJR model to ensure that they are not unfairly penalized due to these circumstances,” said Joanna Hiatt Kim, AHA vice president of payment policy. “For example, CJR beneficiaries in emergency and disaster areas could require unplanned, and possibly extensive, health care services as a direct result of evacuations or emergency-related injuries. In addition, the hospitals themselves may have difficulty completing their quality reporting submissions under the program. They should not be held accountable for these types of circumstances that are well beyond their control.”

Related News Articles

Headline
The Government Accountability Office today named three new members to the Medicare Payment Advisory Commission through April 2023. They are: Wayne…
Headline
More than half of U.S. adults aged 70 and older have experienced a disruption in their medical care during the first month of social distancing for COVID-19,…
Headline
The AHA and other national hospital organizations today urged the Department of Health and Human Services and Centers for Medicare & Medicaid Services to…
Headline
The Medicare Hospital Insurance Trust Fund will have sufficient funds to pay full benefits until 2026, according to the latest annual report from the…
Headline
The Centers for Medicare & Medicaid Services recently granted Section 1135 Medicaid waivers for the COVID-19 emergency to Puerto Rico and the Commonwealth…
Headline
The Centers for Medicare & Medicaid Services clarified that the agency is waiving the Medicare coverage requirement for a three-day prior hospitalization…