CMS proposes first PACE update since 2006

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Andy Slavitt
Andy Slavitt

The Programs of All-Inclusive Care for the Elderly would be updated for the first time since 2006 under a proposal announced Thursday by the Centers for Medicare & Medicaid Services. The proposed rule will be published in the Federal Register on Tuesday (a PDF is available now), with comments due Oct. 17.

The changes, according to CMS, would provide “greater operational flexibility, remove redundancies and outdated information, and codify existing practice” in the program, which enables Medicare and Medicaid beneficiaries to receive care in the community instead of in a nursing home or other care facility.

Among provisions of the proposal:

  • Care team members would be able to participate in more aspects of a participant's care. Currently, members are permitted to fill only one role on the care team.
  • Nonphysician primary caregivers, such as nurse practitioners, would be allowed to provide some services currently provided by primary care physicians.
  • People convicted of physical, sexual or drug or alcohol abuse would be barred from working in positions that could pose a threat to PACE beneficiaries.
  • Sanctions and enforcement actions against PACE organizations would be tightened.

The proposed rule “provides much-needed updates,” Cheryl Phillips, M.D., senior vice president of public policy and health services for LeadingAge, told McKnight's Senior Living. “We are hopeful that the proposed changes in this rule will allow for even greater expansion of this vital option of care for vulnerable older people who would otherwise be at great risk of long-term nursing-home care.”

Expansion is the goal, CMS Acting Administrator Andy Slavitt said in a blog post. “While PACE serves a relatively small number of people today, our proposal is intended to encourage states to further expand these programs,” he wrote.

More than 34,000 seniors are enrolled in 100 PACE organizations in 31 states, CMS said. Enrollment has increased more than 60% since 2011.

In November, President Barack Obama signed into law a bill facilitating the testing of PACE to serve older adults who have not yet meet the standard for a nursing home level of care as well as to serve others.

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