Recent action by the Centers for Medicare and Medicaid Services (CMS) announces significant change in reimbursement methodology for high volume orthopedic surgical procedures in many markets nationwide. Affected stakeholders now await CMS’ final rule following submission of numerous comments to the pending Comprehensive Care for Joint Replacement initiative (CCJR). The proposed CCJR rule will become effective for a five-year period beginning January 1, 2016, unless CMS relents to requests for delay from the American Hospital Association and others.

While the proposal is nuanced and subject to change, several key CCJR issues are summarized below, and underscore the need for affected hospitals and health systems to address CCJR development and related issues on an expedited basis in the changing regulatory environment.