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PACE Proposed Rule Released

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PACE Proposed Rule Released

August 15, 2016
On August 16, the Centers for Medicare and Medicaid Services (CMS) will publish proposed rule RIN 0938-AR60, which will revise and update the requirements for the Programs of All-Inclusive Care for the Elderly (PACE) under the Medicare and Medicaid programs. According to the summary in the proposed rule, it will address application and waiver procedures, sanctions, enforcement actions and termination, administrative requirements, PACE services, participant rights, quality assessment and performance improvement, participant enrollment and disenrollment, payment, federal and state monitoring, data collection, record maintenance, and reporting. The proposed changes will provide greater operational flexibility, remove redundancies and outdated information, and codify existing practice.
 
In recent years, there have been efforts to expand PACE services to non-elderly people with disabilities. A bill permitting demonstrations expanding PACE was signed into law last fall. (See WICs article, "PACE Demonstration Legislation Signed Into Law," November 23, 2015.) ANCOR has contributed significantly to developing recommendations and considerations to be taken into account when attempting to use a PACE-like model to serve this population. 
 
The proposed rule just released appears to impact the current PACE program and does not further expand the program beyond the demonstration authorized. ANCOR is in the process of reviewing the proposed rule and will comment as appropriate. Comments are due on the proposed rule by October 17, 2016.