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.

• Authority: 42 U.S.C. 1302, 1315(a), and 1395hh.
• Source: 80 FR 73540, Nov. 24, 2015, unless otherwise noted.

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

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