(a) General

(1) CJR-X participants, as defined in § 512.605, must participate in CJR-X, except as specified in paragraph (b) of this section.

(2) CJR-X participants will remain CJR-X participants, unless they no longer meet the definition of CJR-X participant, CMS terminates CJR-X, or the CJR-X participant receives notice of termination from CJR-X in accordance with § 512.610(c).

(b) Exclusions. CMS excludes from CJR-X hospitals that meet any of the following criteria:

(1) Is a TEAM participant as defined at § 512.505.

(2) Is located in the State of Maryland.

(c) CJR-X participant termination from CJR-X.

(1) CMS may in its sole discretion terminate a CJR-X participant's participation in the model immediately or upon advance notice if CMS determines:

(i) One or more grounds for remedial action described in § 512.160(a) have occurred with respect to the CJR-X participant; or

(ii) The CJR-X participant's continued participation would be inconsistent with the purposes of CJR-X, the requirements of this part, or applicable law.

(2) If a CJR-X participant receives a notification from CMS of termination from CJR-X and wishes to dispute the termination, it must provide a written notice to CMS requesting review of the termination within 10 calendar days of the notice.

(i) CMS has 30 days to respond to the CJR-X participant's request for review.

(ii) If the CJR-X participant fails to provide timely notification to CMS, the termination is deemed final.

(3) Where a participant is terminated from the CJR-X Model, the participant hospital will remain liable for all negative NPRA generated from episodes of care that ended prior to termination.