Senators push CMS to expand program for long-term care outside nursing homes

Share this content:

The Centers for Medicare & Medicaid Services should loosen regulations to allow more people to receive care in the community rather than in nursing homes, a bipartisan group of Senators wrote in a recent letter to the top CMS official.

It is their “understanding” that CMS is updating the regulations for the Programs of All Inclusive Care for the Elderly, the Senators wrote in the September 17 letter to CMS Administrator Marilyn Tavenner. They offered several recommendations, which they said would improve PACE's “operational flexibility.” Current regulations have stifled the program's growth and limited its reach, they asserted.

PACE organizations should be allowed to offer services in more community settings, such as adult day health centers, the Senators wrote. They also pushed for community physicians to be integrated into PACE interdisciplinary care teams, to enable nurse practitioners to be assigned as primary care providers, and to allow for concurrent federal and state review of PACE provider applications.

The PACE program is designed to fund comprehensive, integrated home- and community-based services for particularly vulnerable beneficiaries eligible for a nursing home level of care. By loosening the regulations, CMS could improve outcomes while spending less for a “larger and more diverse” group of beneficiaries, the Senators argued. PACE enrollees continue to receive benefits through the program even if they do enter a nursing home.

Sens. Tom Carper (D-DE) and Patrick Toomey (R-PA) spearheaded the letter, and 11 of their Senate colleagues signed on.