The CMS is hoping to increase use of a decades-old program meant to care for people who are dually eligible for Medicare and Medicaid by making a few policy tweaks to the program.
The Programs of All-Inclusive Care for the Elderly (PACE) is a provider-based model of care that integrates preventive, primary, acute, behavioral, and long-term supports and services for dual beneficiaries who are at least 55 years old, qualify for nursing facility-level services, and can be served safely in community settings. The agency hasn't released a rule related to the program since 2006.
On Thursday, the CMS proposed allowing non-physician primary-care practitioners to provide some services in place of primary-care physicians.
The agency also proposes lifting restrictions that prevent individual care team members from serving more than one role in addressing a patient's needs. This would help better coordinate services, while providing important flexibility to care providers, the agency said.
The proposed rule also outlines simplified administrative and operational rules to expedite and automate the application process.
PACE began as an experiment in 1983, and 14 years later Congress authorized the program as a permanent part of Medicare and Medicaid in the Balanced Budget Act of 1997.
More than 34,000 older adults are currently enrolled in about 100 PACE organizations in 31 states, and enrollment in PACE has increased by over 60% since 2011, according to the CMS.
Comments on the rule are due Oct. 17.
