CMS will
continue to consider ways to streamline and clarify packages
associated with the PACE program.
Inventory as of this Action
Requested
Previously Approved
12/31/2023
36 Months From Approved
12/31/2020
78,219
0
165
73,149
0
71,455
0
0
0
PACE organizations must demonstrate
their ability to provide quality community-based care for the frail
elderly who meet their State's nursing home eligibility standards
using capitated payments from Medicare and the state. The model of
care includes as core services the provision of adult day health
care and multidisciplinary team case management, through which
access to and allocation of all health services is controlled.
Physician, therapeutic, ancillary, and social support services are
provided in the participant's residence or on-site at the adult day
health center. PACE programs must provide all Medicare and Medicaid
covered services including hospital, nursing home, home health, and
other specialized services. Financing of this model is accomplished
through prospective capitation of both Medicare and Medicaid
payments.
US Code:
42
USC 1395eee Name of Law: PAYMENTS TO, AND COVERAGE OF BENEFITS
UNDER PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
PL:
Pub.L. 108 - 173 902 Name of Law: Medicare Prescription Drug
Improvement and Modernization Act of 2003 (MMA)
US Code: 42
USC 1396U-4 Name of Law: PROGRAM OF ALL-INCLUSIVE CARE FOR THE
ELDERLY (PACE)
PL:
Pub.L. 105 - 33 4801 Name of Law: the Balanced Budget Act of
1997
PL:
Pub.L. 106 - 554 903 Name of Law: Medicare, Medicaid and SCHIP
Benefits Improvement Act of 2000
In this revised PRA package, we
are incorporating changes made to PACE as a result of the final
PACE Rule, CMS-4168-F, published June 3, 2019, which updates the
requirements for PACE under the Medicare and Medicaid programs. The
rule addresses application and waiver procedures, sanctions,
enforcement actions and termination, administrative requirements,
PACE services, participant rights, quality assessment and
performance improvement, participant enrollment and disenrollment,
payment, federal and state monitoring, data collection, record
maintenance, and reporting. The changes will provide greater
operational flexibility, remove redundancies and outdated
information, and codify existing practice. Based on the final pace
rule as well as updated assumptions on wages, the number of POs and
several other factors, this PRA package reduces hour burden from
the active document by 659 (73,149 hours vs. the former 72,490
hours) and increases costs by $119,402 ($4,168,160 vs. the former
4,287,562).
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
CMS-R-244 (CMS-4168-F version 9).docx
Requirements for PACE Entities