CCJR, rather CJR Final Finally :: Reliant Rehab

CCJR, rather CJR Final Finally

https://www.federalregister.gov/articles/2015/11/24/2015-29438/medicare-program-comprehensive-care-for-joint-replacement-payment-model-for-acute-care-hospitals?utm_content=previous&utm_medium=PrevNext&utm_source=Article

Or visit AHCA website resource at

http://www.ahcancal.org/searchcenter/Pages/Results.aspx?k=cjr

Specifically outlined here are the changes in waivers as found in the AHCA summary:

VIII. Program Policy Waivers 

CMS finalized a number of Medicare policy waivers in the CJR program. 

Telehealth Waiver CMS will waive the geographic site requirement and the originating site requirement for telehealth services for patients who fall under CJR. CMS will allow telehealth services to be provided in a CJR beneficiary’s home or residence, and providers will be able to bill for in-home visits under one of 9 new G-codes. 

Post-Discharge Home Visit Waiver CMS will waive the supervision requirement so that clinical staff may provide home visits under general supervision to CJR patients. Providers will be able to bill for these visits under one of 9 new G-codes. 

SNF 3-Day Qualifying Stay Waiver CMS waives the SNF 3-day rule for a CJR beneficiary following the anchor hospitalization only if the SNF meets certain qualification criteria at the time of the beneficiary’s SNF admission. CMS defines a qualified SNF as one that has an overall rating of three stars or better in the Five-Star Quality Rating System for SNFs on the Nursing Home Compare Web site for at least 7 of the 12 preceding months, as determined by CMS based on the most recent rolling 12 months of SNF star rating data available for the calendar quarter that includes the date of the beneficiary’s admission to the SNF. CMS will post the list of qualified SNFs quarterly to the CMS website. If a SNF is on this list, the other requirements for the waiver as listed previously are met, and other existing Medicare coverage requirements are met, the SNF stay for the CJR beneficiary will be covered under Part A under the CJR model SNF 3-day rule waiver. 

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