Updated federal regulations
overseeing PACE programs nationally were released by the Center for Medicare and Medicaid Services (CMS) on June 3 and took effect on August 2. The released final rule is the first comprehensive update of the PACE regulation since 2006.
The updates to the regulation provide new flexibility for PACE programs in several areas, including:
Allowing community based physicians, nurse practitioners, and physician assistants to serve as PACE primary care providers without the use of waivers;
Providing PACE organizations with greater flexibility with respect to involvement of individual
IDT members in scheduled reassessments and unscheduled reassessments due to changes
in health status.
Affording CMS greater flexibility with respect to the frequency of PACE program audits. After a
PACE organization completes an initial three-year trial period, audits no longer are required at
least once every two years. The decision with respect to the frequency of audits post-trial
period are to be based on a risk assessment undertaken by CMS.
Allowing PACE organizations to utilize contracted individuals or entities for marketing
activities if they are appropriately trained on PACE program requirements.