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Electronic Code of Federal Regulations

e-CFR data is current as of January 21, 2020

Title 42Chapter IVSubchapter HPart 510


TITLE 42—Public Health

CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)

SUBCHAPTER H—HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS

PART 510—COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL

rule

Subpart A—GENERAL PROVISIONS

§510.1
Basis and scope.
§510.2
Definitions.
rule

Subpart B—COMPREHENSIVE CARE FOR JOINT REPLACEMENT PROGRAM PARTICIPANTS

§510.100
Episodes being tested.
§510.105
Geographic areas.
§510.110
Access to records and retention.
§510.115
Voluntary participation election.
§510.120
CJR participant hospital CEHRT track requirements.
rule

Subpart C—SCOPE OF EPISODES

§510.200
Time periods, included and excluded services, and attribution.
§510.205
Beneficiary inclusion criteria.
§510.210
Determination of the episode.
rule

Subpart D—PRICING AND PAYMENT

§510.300
Determination of episode quality-adjusted target prices.
§510.305
Determination of the NPRA and reconciliation process.
§510.310
Appeals process.
§510.315
Composite quality scores for determining reconciliation payment eligibility and quality incentive payments.
§510.320
Treatment of incentive programs or add-on payments under existing Medicare payment systems.
§510.325
Allocation of payments for services that straddle the episode.
rule

Subpart E—QUALITY MEASURES, BENEFICIARY PROTECTIONS, AND COMPLIANCE ENFORCEMENT

§510.400
Quality measures and reporting.
§510.405
Beneficiary choice and beneficiary notification.
§510.410
Compliance enforcement.
rule

Subpart F—FINANCIAL ARRANGEMENTS AND BENEFICIARY INCENTIVES

§510.500
Sharing arrangements under the CJR model.
§510.505
Distribution arrangements.
§510.506
Downstream distribution arrangements.
§510.510
Enforcement authority.
§510.515
Beneficiary incentives under the CJR model.
rule

Subpart G—WAIVERS

§510.600
Waiver of direct supervision requirement for certain post-discharge home visits.
§510.605
Waiver of certain telehealth requirements.
§510.610
Waiver of SNF 3-day rule.
§510.615
Waiver of certain post-operative billing restrictions.
§510.620
Waiver of deductible and coinsurance that otherwise apply to reconciliation payments or repayments.
rule

Subparts H-J [Reserved]

rule

Subpart K—MODEL TERMINATION

§510.900
Termination of the CJR model.

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