PACE

On Wednesday, April 5th, CMS issued a final rule that revises the Medicare Advantage (MA or Part C), Medicare Prescription Drug Benefit (Part D), Medicare Cost Plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes related to Star Ratings, marketing and communications, health equity, provider directories, coverage criteria, prior authorization, and network adequacy. Additionally, the final rule also makes permanent the Limited Income Newly Eligible Transition (LI NET) Program and expands eligibility for the full low-income subsidy benefit to individuals with incomes up to 150% of the federal poverty level who meet eligibility criteria.

ADAPTED PACE is an operational framework for a comprehensive, capitated, and community-based service model. Consideration of testing the expansion and adaptation of the PACE (the Program of All-Inclusive Care for the Elderly) model (ADAPTED PACE) to serve new populations was recently made possible by the PACE Innovation Act which granted waiver authority to the Centers for Medicare & Medicaid Services for this purpose.