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GAO-16-282R 1 (2015-12-08)

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G     A              U.S. GOVERNMENT ACCOUNTABILITY OFFICE
441 G St. N.W.
Washington, DC 20548


B-327585


December 8, 2015

The Honorable Orrin G. Hatch
Chairman
The Honorable Ron Wyden
Ranking Member
Committee on Finance
United States Senate

The Honorable Fred Upton
Chairman
The Honorable Frank Pallone, Jr.
Ranking Member
Committee on Energy and Commerce
House of Representatives

The Honorable Kevin Brady
Chairman
The Honorable Sander M. Levin
Ranking Member
Committee on Ways and Means
House of Representatives

Subject: Department of Health and Human Services, Centers for Medicare & Medicaid Services:
       Medicare Program; Comprehensive Care for Joint Replacement Payment Model for
       Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services

Pursuant to section 801 (a)(2)(A) of title 5, United States Code, this is our report on a major rule
promulgated by the Department of Health and Human Services, Centers for Medicare &
Medicaid Services (CMS) entitled 'Medicare Program; Comprehensive Care for Joint
Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint
Replacement Services (RIN: 0938-AS64). We received the rule on November 17, 2015. It was
published in the Federal Register as a final rule on November 24, 2015. 80 Fed. Reg. 73,274.
The rule has an effective date of January 15, 2016, and is applicable on April 1, 2016, when the
first model performance period begins.

The final rule implements a new Medicare Part A and B payment model called the
Comprehensive Care for Joint Replacement (CJR) model. Under this model, acute care
hospitals in certain selected geographic areas will receive retrospective bundled payments for
episodes of care for lower extremity joint replacement or reattachment of a lower extremity. All
related care within 90 days of hospital discharge from the joint replacement procedure will be
included in the episode of care.


GAO-16-282R

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