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CMS Delays New Bundled Payment Models

February 16, 2017

Citing the “Regulatory Freeze”, the U.S. Department of Health and Human Services (HHS) is delaying the implementation of the Centers for Medicare & Medicaid Services (CMS) new bundled payment models and the Substance Abuse and Mental Health Services Administration (SAMHSA) final rule on confidentiality of substance use disorder patient records.

On January 20, the Trump Administration issued a memo to the heads of all executive departments and agencies freezing new and pending federal regulatory activity until the President's appointees or designees have had the opportunity to review any new, recently finalized or pending regulations.

The new effective date for the bundled payment models specific to cardiac care and expanding the current Comprehensive Care for Joint Replacement (CJR) model has been pushed to March 21, 2017. While the new HHS Secretary Tom Price has been supportive of the transition from payment for the volume of services provided to payment for the value of services provided, he has been critical of programs that are mandatory in nature or those that may restrict how hospitals and physicians care for their patients.

Additionally, SAMHSA postponed the effective date of its final rule on confidentiality of substance use disorder patient records for 60 days. The final rule will now take effect on March 21, instead of Feb. 17 as initially published. The rule —the first major update to the confidentiality rule since 1987—allows researchers greater access to substance abuse-related medical records, and lifts the federal requirement that patient consent be obtained every time substance abuse records are shared with a doctor.

HAP is continuing to monitor administrative and regulatory activity and will keep Pennsylvania hospitals informed. Please contact Kate Slatt, senior director, health care finance policy, or Jennifer Jordan, vice president, regulatory advocacy with any questions.

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