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Exemption for hospitals whose ortho docs are participating in BPCI?
A: For hospitals located in MSAs where CJR is mandatory that are already participating in the voluntary BPCI CMS offers the following guidance:
- Hospitals in Model 1, 2 or 4 for the lower joint replacement clinical episode will remain in the BPCI model they are currently participating in and will not be required to participate in the CJR model
 - Participants that terminate from a BPCI model for the lower joint replacement model are required to participate in the CJR since they are located in a MSA where this model is mandatory and no longer participating in a voluntary BPCI model for this clinical condition.
 - Hospitals not currently participating in a voluntary BPCI are required to participate in the CJR model and may not elect to participate in the BPCI model in lieu of CJR.
 - Participating in BPCI model 2 or 3 initiated by participating Physician group practices or post acute care providers will take precedence over the CJR model.