Title 42

PART 510

Part 510 - Comprehensive Care For Joint Replacement Model

PART 510 - COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Authority:42 U.S.C. 1302, 1315(a), and 1395hh. Source:80 FR 73540, Nov. 24, 2015, unless otherwise noted.

42:5.0.1.2.14.1SUBPART A
Subpart A - General Provisions
42:5.0.1.2.14.1.41.1SECTION 510.1
   510.1 Basis and scope.
42:5.0.1.2.14.1.41.2SECTION 510.2
   510.2 Definitions.
42:5.0.1.2.14.2SUBPART B
Subpart B - Comprehensive Care for Joint Replacement Program Participants
42:5.0.1.2.14.2.41.1SECTION 510.100
   510.100 Episodes being tested.
42:5.0.1.2.14.2.41.2SECTION 510.105
   510.105 Geographic areas.
42:5.0.1.2.14.2.41.3SECTION 510.110
   510.110 Access to records and retention.
42:5.0.1.2.14.2.41.4SECTION 510.115
   510.115 Voluntary participation election.
42:5.0.1.2.14.2.41.5SECTION 510.120
   510.120 CJR participant hospital CEHRT track requirements.
42:5.0.1.2.14.3SUBPART C
Subpart C - Scope of Episodes
42:5.0.1.2.14.3.41.1SECTION 510.200
   510.200 Time periods, included and excluded services, and attribution.
42:5.0.1.2.14.3.41.2SECTION 510.205
   510.205 Beneficiary inclusion criteria.
42:5.0.1.2.14.3.41.3SECTION 510.210
   510.210 Determination of the episode.
42:5.0.1.2.14.4SUBPART D
Subpart D - Pricing and Payment
42:5.0.1.2.14.4.41.1SECTION 510.300
   510.300 Determination of episode quality-adjusted target prices.
42:5.0.1.2.14.4.41.2SECTION 510.305
   510.305 Determination of the NPRA and reconciliation process.
42:5.0.1.2.14.4.41.3SECTION 510.310
   510.310 Appeals process.
42:5.0.1.2.14.4.41.4SECTION 510.315
   510.315 Composite quality scores for determining reconciliation payment eligibility and quality incentive payments.
42:5.0.1.2.14.4.41.5SECTION 510.320
   510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems.
42:5.0.1.2.14.4.41.6SECTION 510.325
   510.325 Allocation of payments for services that straddle the episode.
42:5.0.1.2.14.5SUBPART E
Subpart E - Quality Measures, Beneficiary Protections, and Compliance Enforcement
42:5.0.1.2.14.5.41.1SECTION 510.400
   510.400 Quality measures and reporting.
42:5.0.1.2.14.5.41.2SECTION 510.405
   510.405 Beneficiary choice and beneficiary notification.
42:5.0.1.2.14.5.41.3SECTION 510.410
   510.410 Compliance enforcement.
42:5.0.1.2.14.6SUBPART F
Subpart F - Financial Arrangements and Beneficiary Incentives
42:5.0.1.2.14.6.41.1SECTION 510.500
   510.500 Sharing arrangements under the CJR model.
42:5.0.1.2.14.6.41.2SECTION 510.505
   510.505 Distribution arrangements.
42:5.0.1.2.14.6.41.3SECTION 510.506
   510.506 Downstream distribution arrangements.
42:5.0.1.2.14.6.41.4SECTION 510.510
   510.510 Enforcement authority.
42:5.0.1.2.14.6.41.5SECTION 510.515
   510.515 Beneficiary incentives under the CJR model.
42:5.0.1.2.14.7SUBPART G
Subpart G - Waivers
42:5.0.1.2.14.7.41.1SECTION 510.600
   510.600 Waiver of direct supervision requirement for certain post-discharge home visits.
42:5.0.1.2.14.7.41.2SECTION 510.605
   510.605 Waiver of certain telehealth requirements.
42:5.0.1.2.14.7.41.3SECTION 510.610
   510.610 Waiver of SNF 3-day rule.
42:5.0.1.2.14.7.41.4SECTION 510.615
   510.615 Waiver of certain post-operative billing restrictions.
42:5.0.1.2.14.7.41.5SECTION 510.620
   510.620 Waiver of deductible and coinsurance that otherwise apply to reconciliation payments or repayments.
42:5.0.1.2.14.8SUBPART H
Subparts H-J [Reserved]
42:5.0.1.2.14.9SUBPART K
Subpart K - Model Termination
42:5.0.1.2.14.9.41.1SECTION 510.900
   510.900 Termination of the CJR model.