I 
114TH CONGRESS 
2D SESSION 
H. R. 4848 
To delay and suspend implementation of a comprehensive care for joint 
replacement (CJR) payment model for episode-based payment for lower 
extremity joint replacement (LEJR) under the Medicare program in 
a budget neutral manner. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 23, 2016 
Mr. TOM PRICE of Georgia (for himself and Mr. DAVID SCOTT of Georgia) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committee on Ways and 
Means, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To delay and suspend implementation of a comprehensive 
care for joint replacement (CJR) payment model for 
episode-based payment for lower extremity joint replace-
ment (LEJR) under the Medicare program in a budget 
neutral manner. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Healthy Inpatient Pro-
cedures Act of 2016’’ or the ‘‘HIP Act’’. 
VerDate Sep 11 2014 
03:54 Mar 24, 2016
Jkt 059200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H4848.IH
H4848
smartinez on DSK9F6TC42PROD with BILLS
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Patient choice has a uniquely positive influ-
ence in achieving quality, responsiveness, effective-
ness, and efficiency of health care services. 
(2) The implementation of a Medicare payment 
model for comprehensive care for joint replacement 
(CJR) represents a significant change to the health 
care delivery system which could have a negative im-
pact on patient choice, access, and quality. 
(3) Patients with higher-cost complex surgeries 
(such as hip fractures and ankle replacement proce-
dures) or who suffer from multiple chronic condi-
tions may especially be at risk in the implementation 
of that model. 
(4) The implementation of that model begin-
ning April 1, 2016, provides physicians, hospitals, 
and post-acute providers with inadequate time to 
prepare for this abrupt shift in payment for these 
high-volume procedures and the changes in care de-
livery that they require. 
VerDate Sep 11 2014 
03:54 Mar 24, 2016
Jkt 059200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H4848.IH
H4848
smartinez on DSK9F6TC42PROD with BILLS
SEC. 3. DELAY AND SUSPENSION OF IMPLEMENTATION OF 
A COMPREHENSIVE CARE FOR JOINT RE-
PLACEMENT 
(CJR) 
MEDICARE 
PAYMENT 
MODEL FOR LOWER EXTREMITY JOINT RE-
PLACEMENT (LEJR) IN A BUDGET NEUTRAL 
MANNER. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall not implement (and shall suspend 
any further implementation of) before January 1, 2018, 
the testing of a Comprehensive Care for Joint Replace-
ment Model (CJR) (described in the rule published in the 
Federal Register on November 24, 2015 (80 Fed. Reg. 
73274–73554)) to be conducted under section 1115A of 
the Social Security Act (42 U.S.C. 1315a) as an episode- 
based payment model for lower extremity joint replace-
ment (LEJR). This section shall not apply to implementa-
tion of such model that has occurred before the date of 
the enactment of this Act. 
(b) CONSTRUCTION.—Nothing in this section shall be 
construed to affect the authority of the Secretary to re-
quire the participation of providers of services, suppliers, 
and beneficiaries in the testing or expansion of any other 
innovative payment and service delivery model under sec-
tion 1115A of the Social Security Act (42 U.S.C. 1315a). 
(c) 
OFFSETTING
ADDITIONAL
EXPENDITURES 
THROUGH REDUCTIONS IN AMOUNTS APPROPRIATED TO 
VerDate Sep 11 2014 
03:54 Mar 24, 2016
Jkt 059200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4848.IH
H4848
smartinez on DSK9F6TC42PROD with BILLS
THE PREVENTION AND PUBLIC HEALTH TRUST FUND.— 
Notwithstanding any other provision of law, the amount 
otherwise appropriated to the Prevention and Public 
Health Trust Fund under section 4002(b) of the Public 
Health Service Act (42 U.S.C. 300u–11(b))— 
(1) for fiscal year 2017 is reduced (and re-
scinded) by $180,000,000 (or $185,000,000 if this 
Act is enacted before July 1, 2016); and 
(2) for fiscal year 2018 is reduced (and re-
scinded) by $50,000,000. 
Æ 
VerDate Sep 11 2014 
03:54 Mar 24, 2016
Jkt 059200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6301
E:\BILLS\H4848.IH
H4848
smartinez on DSK9F6TC42PROD with BILLS