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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:

  1. 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
  2. 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.
  3. 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.
  4. 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.