PACE programs will have new flexibility under a recent update of regulations governing Programs of All-Inclusive Care.

As described by the National Association of Medicaid Directors, the new regulation

  • Allows PACE team members to fulfill multiple roles on the care team;
  • Allows certain non-physician providers to serve in the place of primary care physicians on the care team;
  • Clarifies that PACE programs offering prescription drug benefits are subject to Medicare Part D regulations;
  • Eliminates requirements for PACE organizations to seek waivers for several of the most commonly waived aspects of PACE regulation; and
  • Updates CMS’s enforcement actions to promote accountability in PACE.

PACE, as described in the CMS fact sheet announcing the regulation update,

… provides comprehensive medical and social services to certain frail, elderly individuals who qualify for nursing home care but, at the time of enrollment, can still live safely in the community. The majority of participants served by PACE are dually eligible for both Medicare and Medicaid. More than 45,000 older adults are currently enrolled in more than 100 PACE organizations in 31 states…

Learn more from the CMS fact sheet describing the updated regulation or go here to see the regulation itself.