CMS proposes first PACE update in 10 years

The Programs of All-Inclusive Care for the Elderly would get its first major update in a decade
The Programs of All-Inclusive Care for the Elderly would get its first major update in a decade

The Programs of All-Inclusive Care for the Elderly would get its first major update in a decade under a proposal announced by the Centers for Medicare & Medicaid Services Thursday.

The PACE program, last overhauled in 2006, provides coordinated, community-based services to Medicare and Medicaid beneficiaries who qualify for skilled nursing care.

The new proposal would allow for “a more flexible approach” to coordinating participants' care teams than the current structure, which only allows team members to fill one role on a care team. Non-physician primary caregivers such as nurse practitioners would also be allowed to provide some services instead of primary care physicians. 

That addition will make beneficiaries' care teams "really flexible," Jade Gong, principal at Jade Gong and Associates, told McKnight's.

"That's something that everyone's wanted for a long time, so that's very positive," Gong said.

Additional updates to the PACE care teams includes provisions that would block people with convictions for physical, sexual, or drug or alcohol abuse from being employed in a position that could pose a threat to PACE beneficiaries. Sanctions and enforcement actions against PACE organizations would also tightened under the proposal.

“The goal of this proposal is to strengthen beneficiary protections and provide PACE organizations with more administrative and operational flexibilities so they can do what they do best — caring for our nation's most vulnerable individuals,” wrote CMS acting administrator Andy Slavitt 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.”

The proposal would also usher in more frequent updates to the PACE Program Agreement, which would make regulations “more consistent, transparent, and comprehensible.”

There currently more than 34,000 seniors enrolled in 100 PACE organizations in 31 states, CMS said. A Senate bill to expand PACE for testing in younger populations was passed last year.