House Bill Directs CMS to Issue Long-Delayed PACE Rule

Long-awaited final rules for Programs for All-Inclusive Care for the Elderly (PACE) could be coming this year, thanks to a bill working its way through the House of Representatives.

PACE programs utilize mixed funds from Medicare, Medicaid and private sources to offer a full range of services and support to individuals who are at least 55 years old and would otherwise qualify to be in a nursing home. The idea is that by offering wrap-around care — including home health and private duty services — through an interdisciplinary team, PACE will increase enrollees’ wellbeing while keeping overall health system costs down. More than 90% of PACE participants live in the community, not in a nursing home, according to the National PACE Association.

PACE is relatively small in scale, with about 45,000 in total enrollments across 31 states. However, the program has generated interest as a more person-centered model of care delivery, which also helps people to age in place. Yet the program has been in regulatory limbo for about two years.


In 2016, the Centers for Medicare & Medicaid Services (CMS) proposed updated rules governing the PACE program, including staffing standards and other compliance issues. However, a final version of these rules has not been forthcoming.

“It’s been pretty slow moving,” Joy Cameron, vice president of policy and innovation at ElevatingHome, told Home Health Care News. “I have friends who work over [in PACE], and they’ve been pretty frustrated.”

The House of Representatives is taking action, in the form of H.R. 6561, the “Comprehensive Care for Seniors Act of 2018.” This piece of legislation calls for CMS to issue the final PACE rule by Dec. 31, 2018. The measure has bipartisan support. It was introduced by Rep. Jackie Walorski, a Republican from Indiana. Four other Republicans and three Democrats are cosponsors.


Last Thursday, members of the House Ways and Means Committee approved the bill by a voice vote, ThinkAdvisor reported. The National PACE Association expects that the bill will come up for a full vote in the House later this week.

More certainty around PACE could be good news for home care and home health providers, which have a role to play in serving PACE enrollees.

“It’s a type of care we’ve shared with our members as an opportunity for them to partner,” Cameron said. “It’s something we keep our eyes on because we look at all types of community-based care.”

Written by Tim Mullaney

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