CMS finalizes rule updating Programs of All-Inclusive Care for the Elderly

The Centers for Medicare & Medicaid Services yesterday issued a final rule updating Medicare and Medicaid requirements for the more than 100 Programs of All-Inclusive Care for the Elderly in 31 states, the first major update since 2006. CMS said the changes will provide greater operational flexibility, remove redundancies and outdated information, and codify existing practice. For example, the rule finalizes AHA-supported provisions in the 2016 proposed rule that expand the definition of primary care practitioner for the interdisciplinary care team to include non-physician caregivers, such as nurse practitioners or physician assistants; allow interdisciplinary team members to fulfill multiple clinical roles; enhance screening protocols for hiring employees; and require state Medicaid capitation payments to be linked to a general payment standard. PACE is a unique model of risk-based integrated care for frail elderly individuals. Enrollment in the programs has increased by 120 percent since 2011 to more than 45,000 older adults, most of whom are eligible for both Medicare and Medicaid.