# Medicare Program; Cancellation of Advancing Care Coordination Through Episode Payment and Cardiac Rehabilitation Incentive Payment Models; Changes to Comprehensive Care for Joint Replacement Payment Model: Extreme and Uncontrollable Circumstances Policy for the Comprehensive Care for Joint Replacement Payment Model
> **Centers for Medicare and Medicaid Services** · Final rule; interim final rule with comment period. · Published 2017-12-01 · Effective 2018-01-01 · 82 FR 57066
## Document
- **Document number:** 2017-25979
- **Category:** medicare
- **Sub-agency:** Centers for Medicare and Medicaid Services
- **Federal Register citation:** 82 FR 57066
- **CFR reference:** 42 CFR 510
- **Publication date:** 2017-12-01
- **Effective date:** 2018-01-01
- **HHS docket:** CMS-5524-F and IFC
## Abstract

This final rule cancels the Episode Payment Models (EPMs) and Cardiac Rehabilitation (CR) Incentive Payment Model and rescinds the regulations governing these models. It also implements certain revisions to the Comprehensive Care for Joint Replacement (CJR) model, including: Giving certain hospitals selected for participation in the CJR model a one-time option to choose whether to continue their participation in the model; technical refinements and clarifications for certain payment, reconciliation and quality provisions; and a change to increase the pool of eligible clinicians that qualify as affiliated practitioners under the Advanced Alternative Payment Model (Advanced APM) track. An interim final rule with comment period is being issued in conjunction with this final rule in order to address the need for a policy to provide some flexibility in the determination of episode costs for providers located in areas impacted by extreme and uncontrollable circumstances.

## Source
- [Federal Register document](https://www.federalregister.gov/documents/2017/12/01/2017-25979/medicare-program-cancellation-of-advancing-care-coordination-through-episode-payment-and-cardiac)
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