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 The changes will provide greater operational flexibility, remove redundancies and outdated information, and codify existing practice.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