CMS updates team-based home care program

With enrollment in Programs of All-Inclusive Care for the Elderly (PACE) increasing by 60 percent in the past five years, CMS is proposing changes to “modernize” the team-based home care services program for Medicare and Medicaid beneficiaries.

PACE has been relatively unchanged since 2006, but with an aging population, CMS said more than 34,000 elderly patients are now enrolled in 100 organizations across 31 states. CMS Acting Administrator Andy Slavitt said the updates are needed to meet the program’s goals of keeping patients out of nursing homes and receiving care in their communities.

“Our proposals aim to offer the kind of common sense supports to allow older adults to get the best care possible,” Slavitt said in a blog post. “For example, individual care team members would be able to serve more than one role in addressing the wide spectrum of a participant’s needs, rather than just the one role they are permitted to occupy today. This would help better coordinate services, while providing important flexibility to care providers.”

The proposed rule contains other measures aimed at assisting PACE organizations, such as allowing non-physician primary care practitioners to provide some services currently reserved only for primary care physicians. Slavitt also said operational and administrative rules would be “simplified” and the application process would be sped up with greater automation.

Along with those provider-friendly updates would be new protections for beneficiaries. The proposed rule would require PACE organizations offering prescription coverage to comply with Medicare Part D standards and new enforcement and sanctions rules would be added. Additionally, new restrictions for workers would be added, banning anyone with criminal convictions for physical, sexual, drug or alcohol abuse from being “employed in any capacity where their contact would pose a potential risk to beneficiaries.”

Comments on the proposed rule will be accepted through Oct. 17.