HHS Secretary Thomas Price and CMS Administrator Seema Verma have signaled that the Trump Administration is eyeing changes to one of the last major Medicare policies issued by the Obama Administration. Specifically, CMS is delaying a January 3, 2017 final rule that established mandatory Medicare episode payment models (EPM) for acute myocardial infarction, coronary artery bypass graft, and surgical hip/femur fracture treatment procedures furnished in designated geographic areas. The rule also made conforming changes to the Comprehensive Care for Joint Replacement (CJR) program. The rule was originally scheduled to go into effect February 18, 2017, but major provisions (including the EPM start date and CJR changes) were not scheduled to be implemented until July 1, 2017. Last month, the Trump Administration published a notice pushing the effective date to March 21, but it did not impact the July 1, 2017 implementation date.

In an interim final rule with comment period published today, CMS is making the following changes to the EPM/CJR timeline:

  • CMS is delaying until October 1, 2017 the implementation date of the EPM/CJR provisions that were scheduled to go into effect July 1, 2017.
  • The general effective date of the rule is being delayed two months, from March 21 to May 20, 2017.

Furthermore, CMS is soliciting comments on whether the October 1 implementation date should be delayed until January 1, 2018 to provide additional time to “undertake notice and comment rulemaking to modify the policy if modifications are warranted.” According to CMS, such a delay would ensure that participants “are not required to take needless compliance steps” if additional changes to the rule are made. Comments will be accepted until April 19, 2017.