CMS has finalized an "extreme and uncontrollable circumstances policy" for the Comprehensive Care for Joint Replacement (CJR) payment model. Under this policy, which was prompted by severe hurricanes and wildfires, CMS will exercise flexibility in the determination of episode spending for CJR participant hospitals located in areas impacted by extreme and uncontrollable circumstances for performance years 3 through 5. As in the earlier interim final rule with comment period published on December 1, 2017, this policy caps actual episode payments at the episode target prices for (1) a non-fracture episode with a date of admission to the anchor hospitalization that is on or within 30 days before the date that the emergency period (as defined), or (2) a fracture episode with a date of admission to the anchor hospitalization that is on or within 30 days before or after the date that the emergency period.
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