The Centers for Medicare & Medicaid Services (CMS) is delaying until January 1, 2018 implementation of mandatory Medicare episode payment models (EPMs) for acute myocardial infarction, coronary artery bypass graft, and surgical hip/femur fracture treatment procedures furnished in designated geographic areas. Conforming changes to the Comprehensive Care for Joint Replacement (CJR) program also are being pushed back to 2018, as is the start of a new Cardiac Rehabilitation (CR) Incentive Payment Model. These policies initially were scheduled to be implemented July 1, 2017, but the Trump Administration subsequently postponed them until October 1, 2017.
In announcing the new 2018 start date, CMS again raised the possibility that it will propose additional modifications to the programs; indeed, a Trump Administration proposed rule to revise the EPM, CJR, and CR programs is currently under Office of Management and Budget review. Thus, the delay until 2018 is intended to ensure program participants have “a clear understanding of the governing rules before episodes begin and have the opportunity to take additional steps to adjust to any potential changes that maybe effectuated.”