Home Health & Hospice Week

Medicare has made the first major changes to PACE regulations since 2006, the Centers for Medicare & Medicaid Services notes in a release. They come after enrollment in Program of All-inclusive Care for the Elderly programs has grown 120 percent since 2011. More than 45,000 seniors are currently enrolled in more than 100 PACE organizations in 31 states.

A final rule published in the June 3 Federal Register includes revisions ranging from imposing new sanctions to codifying administrative procedures, according to the release. CMS touts the sanctions, including Civil Money Penalties, as a way to avoid termination of PACE programs, while critics say they will just result in increased costs for PACE providers.

“The changes we are making to the PACE program will help to protect our seniors from abuse and neglect,” CMS Administrator Seema Verma says in the release.

Another notable change “is CMS’ revision to the regulations at §460.98(c)(1) and §460.102(c),” points out the National Association for Home Care & Hospice. “CMS will permit primary care services to be provided by nurse practitioners (NP) and physician assistants (PA). Additionally, the primary care provider on the interdisciplinary team (IDT) in PACE programs may be filled by an NP or PA.” Those roles formerly could only be served by a physician.

Try this: “CMS’ position on NPPs in the PACE program may provide some leverage when meeting with your Congressional delegation to advocate that NPPs be permitted to certify and order home health services,” NAHC suggests in its member newsletter.

The 68-page rule is at www.govinfo.gov/content/pkg/FR-2019-06-03/pdf/2019-11087.pdf.