e-CFR data is current as of January 21, 2020
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
Subpart A—GENERAL PROVISIONS
Subpart B—COMPREHENSIVE CARE FOR JOINT REPLACEMENT PROGRAM PARTICIPANTS
|
| Access to records and retention. |
|
|
| Voluntary participation election. |
|
|
| CJR participant hospital CEHRT track requirements. |
|
Subpart C—SCOPE OF EPISODES
|
| Time periods, included and excluded services, and attribution. |
|
|
| Beneficiary inclusion criteria. |
|
|
| Determination of the episode. |
|
Subpart D—PRICING AND PAYMENT
|
| Determination of episode quality-adjusted target prices. |
|
|
| Determination of the NPRA and reconciliation process. |
|
|
| Composite quality scores for determining reconciliation payment eligibility and quality incentive payments. |
|
|
| Treatment of incentive programs or add-on payments under existing Medicare payment systems. |
|
|
| Allocation of payments for services that straddle the episode. |
|
Subpart E—QUALITY MEASURES, BENEFICIARY PROTECTIONS, AND COMPLIANCE ENFORCEMENT
|
| Quality measures and reporting. |
|
|
| Beneficiary choice and beneficiary notification. |
|
Subpart F—FINANCIAL ARRANGEMENTS AND BENEFICIARY INCENTIVES
|
| Sharing arrangements under the CJR model. |
|
|
| Distribution arrangements. |
|
|
| Downstream distribution arrangements. |
|
|
| Beneficiary incentives under the CJR model. |
|
Subpart G—WAIVERS
|
| Waiver of direct supervision requirement for certain post-discharge home visits. |
|
|
| Waiver of certain telehealth requirements. |
|
|
| Waiver of SNF 3-day rule. |
|
|
| Waiver of certain post-operative billing restrictions. |
|
|
| Waiver of deductible and coinsurance that otherwise apply to reconciliation payments or repayments. |
|
Subparts H-J [Reserved]
Subpart K—MODEL TERMINATION
|
| Termination of the CJR model. |
|
| 
