Become a PACE Provider
Organizations interested in becoming a PACE provider will need to apply.
The following items should be considered:
- PACE provider application.
- Participant rights template.
- PACE Program Agreement.
Existing Provider Expansion
PACE Organizations can expand their service area or add a new PACE center by submitting a PACE Expansion Application. There are three scenarios under which a PACE provider may expand operations. Each scenario contains a list of steps that must be followed for expansion approval.
- Scenario 1
A PACE Organization requests to expand its geographic service area without building additional sites. PO must obtain approval for expansion from State Medicaid Agency (SMA) and State Administering Agency (SAA). PO and SAA collaborate on the provider application in its entirety. To the extent the expanded service area reflects the same processes as the already approved service area of the provider, the application can note this without resubmitting approved material. CMS reviews and renders a decision on the application. If approved, the Program Agreement's Appendix C is amended to reflect the new service area.
- Scenario 2
A PACE Organization requests to open another physical site in the existing geographic service area. PO must obtain approval for expansion from SMA and SAA. PO and SAA collaborate on the provider application in its entirety. To the extent the new site adopts the same processes as the already approved sites of the provider, the application can note this without resubmitting approved material. The SAA conducts a readiness review of the new site while the clock is stopped. CMS reviews and renders a decision on the application. If approved, the Program Agreement's Appendix C is amended to reflect the new site.
- Scenario 3
A PACE Organization requests to expand its geographic service area and open another physical site in the expanded area. PO must obtain approval for expansion from SMA and SAA. PO and SAA collaborate on the provider application in its entirety. To the extent the new site adopts the same processes as the already approved sites of the provider, the application can note this without resubmitting approved material. The SAA conducts a readiness review of the new site while the clock is stopped. CMS reviews and renders a decision on the application. If approved, the Program Agreement's Appendix C is amended to reflect the new geographic area and new site.
Comprehensive details and steps to become a PACE provider are outlined here: www.Medicaid.gov.