CHA News Article

CMS Issues Final PACE Rule
For Post-Acute Care Leaders, Case Managers, Reimbursement Staff

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule revising and updating requirements for Programs for All-Inclusive Care for the Elderly (PACE). PACE provides comprehensive medical and social services to individuals who qualify for nursing home care but can still live safely in the community.

The majority of PACE enrollees are dually eligible for both Medicare and Medicaid/Medi-Cal. The changes in the final rule are effective Aug. 2. 

According to CMS, the changes are being made to provide greater operational flexibility and strengthen protections and improve care for PACE participants, including clarifications to enrollment policies, quality improvement, and other requirements. Other notable changes include: 

  • Greater flexibility in composition of the interdisciplinary team
  • Ability of non-physician practitioners to provide some primary care services
  • Clarification that PACE programs must comply with Medicare Part D requirements
  • Changes to enforcement actions, including sanctions and civil monetary penalties 

 

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