FAQ

What kind of information is the patient given in regards to this new model. The push is for these patients to be in and out of SNF in 10 days or less and yet they have no idea why we are doing that.

Q: Is this going to be told to them at the hospital?

A: Great question. Beneficiary notification requirement focuses the attention of all parties on the requirement to provide all medically necessary care and services. Providers and supplier involved in risk sharing with the hospital are required to notify the beneficiary of the payment model. In other words, if your facility has entered into a collaborating relationship with the hospital under the CJR model you are required to notify the beneficiary of the payment model. If there are no risk sharing agreements then the hospital must notify the beneficiary of any payment implications

CMS has provided a beneficiary notification for this purpose that is not modifiable except where indicated on the form. This form can be accessed at the following link:

https://innovation.cms.gov/Files/x/cjr-beneletter-hospital.pdf

CMS recommends that hospitals and all collaborating providers maintain a list of all beneficiaries who receive this notification to aid in monitoring compliance efforts.