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Reminder for PACE and Medicare Advantage Organizations

The Centers for Medicare and Medicaid Services (CMS) requests that current and prospective Medicare Advantage and Program of All-Inclusive Care for the Elderly (PACE) organizations review their parent organization and legal entity name as listed in the Health Plan Management System (HPMS). Any corrections or changes should be communicated by email to CMS by March 16th. The CMS letter available here outlines the path to access the HPMS Basic Contract Management Module where the name is listed, as well as the email to which changes should be reported.

CMS will host a user group webinar that will present an overview of risk adjustment for PACE organizations, along with CMS updates and a question and answer session, on Feb. 20th from 2 to 3 p.m. Registration with a valid contract number is required by Feb. 18th. More information about the event and registration links are available here.

Additionally, CMS has posted the final audit protocol for PACE to the Agency's website. The protocol and supporting data collection instruments (CMS-10630) will be used for PACE audits beginning in 2020 and are available for download here.

The Medicare Parts C and D Oversight and Enforcement Group (MOEG) highly encourages the industry to review this protocol, including the data and documentation requests, in preparation for any upcoming audits, since PACE organizations will be expected to fully comply with the audit protocol and the associated data collection efforts.

LeadingAge NY Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841