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The Centers for Medicare & Medicaid Services (CMS) has notified hospitals participating in the Comprehensive Care for Joint Replacement (CJR) Model that they must make selections to participate in either Track 1 or Track 2 of the model by Oct. 24 at 5 p.m. (PT). Track 1 of the CJR model is considered an Advanced Alternative Payment Model (APM) under requirements of the Medicare Access and CHIP Reauthorization Act (MACRA). Participation in Track 1 requires hospitals to attest to the use of Certified Electronic Health Record Technology, as defined in 42 CFR Section 414.1305, to document and communicate clinical care to their patients or other health care providers, and to submit a financial arrangement list of CJR collaborators. CJR collaborators of the Track 1 participant hospitals and the practice collaboration agents of CJR collaborators are eligible to earn a 5 percent APM incentive payment under the Quality Payment Program, provided they achieve threshold levels of participation in Advanced APMs to attain qualifying APM participant (QP) status for a year.
CMS also notes that hospitals that previously selected Track 2 participation may revise their election to Track 1. Track selection can be made by filling out the attached Excel spreadsheet and sending it to CJRSupport@cms.hhs.gov. A document providing additional instructions is attached.
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On Jan. 20, the Trump Administration issued a memo to the heads of all executive departments and agencies freezing new and pending federal regulatory activity until the President’s appointees or designees have had the opportunity to review any new, recently finalized or pending regulations. The memo, which is common for an incoming administration, addresses regulations that have been sent to the Office of the Federal Register but not yet published, as well as regulations that have been published in the Federal Register but were not yet effective on Jan. 20.
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Webinar Recorded Live on April 30, 2015
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Overview
The National Labor Relations Board (NLRB) has been altering the workplace landscape for the last several years. Two recent and important NLRB changes will significantly impact employers — union and non-union alike.
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CHA has submitted the attached comments to the Office of Medicare Hearings and Appeals (OMHA), responding to its request for information (RFI) on initiatives to address the current backlog of claims pending at the administrative law judge (ALJ) level of appeals. While CHA applauds OMHA’s willingness to begin to address the backlog through a number of pilot programs, the increase in recovery audit contractor (RAC) claim denials will intensify challenges at the ALJ level without fundamental RAC reform. CHA urges OMHA to improve the transparency of data by continuing to release it on a quarterly basis and including additional information, such as the total number of claims, total charges being appealed by the individual Medicare payment system, the most frequent reason for appeals, the number of requests overturned on appeal and the number of cases that moved to the ALJ level. CHA also urges OMHA to improve communication on its established pilots, such as hosting a provider call to educate hospitals on the methodology of its statistical sampling pilot.
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CHA has issued the attached detailed summary, prepared by Health Policy Alternatives, Inc., on the Centers for Medicare & Medicaid Services (CMS) final rule implementing the Comprehensive Care for Joint Replacement (CJR) payment model. The summary is in addition to the previously issued executive summary of key provisions. CMS has finalized the start date for this program as April 1, 2016, a slight delay from the proposed start date of Jan. 1, 2016. The model will require participation from inpatient prospective payment system hospitals in three California metropolitan statistical areas: Los Angeles-Long Beach-Anaheim (Orange County and Los Angeles County); Modesto (Stanislaus County); and San Francisco-Oakland-Hayward (Alameda County, Contra Costa County, San Francisco County, San Mateo County and Marin County). A complete list of hospitals CMS believes to be subject to the CJR program is also attached.
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