In an Interim Final Rule with Comment Period (IFC) published on March 21, 2017, CMS provided that implementation of the EPMs for cardiac and orthopedic care improvement, the cardiac rehabilitation incentive payment model, and the changes to the Comprehensive Care for Joint Replacement (CJR) model would be delayed from July 1, 2017 to October 1, 2017.

The final rules being delayed were published on January 3, 2017 by the outgoing administration. The EPM rules call for mandatory participation by hospitals within certain geographical areas—a feature that drew criticism from current Secretary of Health and Human Services Secretary Tom Price, among others.

Further changes or additional delays to the EPMs may be forthcoming. The IFC indicates that the implementation “delay is necessary to allow time for additional review, to ensure that the agency has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are warranted, and to ensure that in such a case participants have a clear understanding of the governing rules . . . .” The delay may be designed to afford time for the development and promulgation of substantive changes to the models.

The IFC also specifically requests “comment on a longer delay of the applicability (model start) date, including to January 1, 2018 . . . .” CMS notes that the delay from July 1 to October 1 would leave performance year 2017 uncommonly short at only three months. This express invitation for comments suggests that CMS is at least open to—and likely is already considering—the possibility of further delay.