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Division of Medicare Advantage Operations

Programs of All-Inclusive Care for the Elderly

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Guidance resources for Division of Medicare Advantage Operations (DMAO)
Programs of All-Inclusive Care for the Elderly (PACE)

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<div class="row"><div class="col-lg-4 col-sm-12 text-center" id="guidance"><a class="collapsed" data-parent="#detail-panel-group" data-target="#guidance-detail-section" data-toggle="collapse"><img alt="Guidance" class="img-circle if-collapsed" data-holder-rendered="true" height="93" src="/pacemailbox/Content/lmi/images/guidance01.png" width="93" /><img alt="Guidance" class="img-circle if-not-collapsed" data-holder-rendered="true" height="93" src="/pacemailbox/Content/lmi/images/minus_icon.png" width="93" /></a><h3><a class="collapsed" data-parent="#detail-panel-group" data-target="#guidance-detail-section" data-toggle="collapse">Guidance</a></h3><p>CMS guidance documents related to PACE.</p></div><div class="col-lg-4 col-sm-12 text-center" id="questions"><a class="collapsed" data-parent="#detail-panel-group" data-target="#questions-detail-section" data-toggle="collapse"><img alt="Questions & Answers" class="img-circle if-collapsed" data-holder-rendered="true" height="93" src="/pacemailbox/Content/lmi/images/questions01.png" width="93" /><img alt="Questions & Answers" class="img-circle if-not-collapsed" data-holder-rendered="true" height="93" src="/pacemailbox/Content/lmi/images/minus_icon.png" width="93" /></a> <h3><a class="collapsed" data-parent="#detail-panel-group" data-target="#questions-detail-section" data-toggle="collapse">Questions &amp; Answers</a></h3><p>Answers to previously asked questions.</p></div><div class="col-lg-4 col-sm-12 text-center" id="resources"><a class="collapsed" data-parent="#detail-panel-group" data-target="#resources-detail-section" data-toggle="collapse"><img alt="Resources" class="img-circle if-collapsed" data-holder-rendered="true" height="93" src="/pacemailbox/Content/lmi/images/resources01.png" width="93" /><img alt="Resources" class="img-circle if-not-collapsed" data-holder-rendered="true" height="93" src="/pacemailbox/Content/lmi/images/minus_icon.png" width="93" /></a> <h3><a class="collapsed" data-parent="#detail-panel-group" data-target="#resources-detail-section" data-toggle="collapse">Resources</a> </h3><p>Resources if your questions do not relate to PACE.</p></div></div>

Guidance

CMS guidance documents related to PACE.

Questions & Answers

Answers to previously asked questions.

Resources

Resources if your questions do not relate to PACE.

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Please review the available guidance documents and the resources below that may answer your question.

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<div id="detailsContainer2"><div class="ma-details-row"><p><a href="https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2020.pdf" re_target="_blank" target="_blank" title="CY 2019 Call Letter">CY 2020 Advance Notice and Call Letter April 1, 2019</a><br /><br /><a href="/pacemailbox/Documents/2018%20PACE%20Application%20Guidance%20and%20Training%20Announcement.pdf" re_target="_blank" target="_blank" title="CY 2016 PACE Application Guidance HPMS Memo December 11, 2015"></a><a href="/pacemailbox/S3Browser/GetFile?path=2018%20PACE%20Application%20Guidance%20and%20Training%20Announcement.pdf">2018 PACE Application Guidance and Training Announcement</a><br /><br /><a href="https://www.cms.gov/Medicare/Health-Plans/PACE/Downloads/PACE_Application_Training_February_7_2018.pdf" target="_blank">Overview of the PACE Application Process_February 7, 2018</a><br /><br /><a href="https://www.cms.gov/Medicare/Health-Plans/PACE/Downloads/HPMS_Pace_Application_Training_February_7_2018.pdf" target="_blank">HPMS ePace_Application_Training_February 7, 2018</a><br /><br /><a href="http://www.ecfr.gov/cgi-bin/text-idx?SID=a3fe0a6a52f47235c57d9b04bea47999&amp;node=42:4.0.1.3.16&amp;rgn=div5" re_target="_blank" target="_blank" title="PACE Regulation">PACE Regulation</a><br /><br /><a href="http://cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS019036.html?DLPage=2&amp;DLSort=0&amp;DLSortDir=ascending" re_target="_blank" target="_blank" title="PACE Manual System ">PACE Manual System </a><br /><br /><a href="/pacemailbox/S3Browser/GetFile?path=NP%20and%20CB%20PCP%20waiver%20checklist%20041715.pdf" re_target="_blank" target="_blank" title="NP and CB PCP Waiver Checklist April 17, 2015">NP and CB PCP Waiver Checklist_April 17, 2015</a><br /><br /><a href="/pacemailbox/S3Browser/GetFile?path=New%20Quarterly%20Submission%20Process%20of%20Waivers%20for%20PACE%20Organizations.pdf">New Quarterly Submission Process of Waivers for PACE Organizations_October 30, 2017</a><br /><br /><a href="/pacemailbox/S3Browser/GetFile?path=PACE%20Waiver%20Memo%204%2021%2015.pdf" re_target="_blank" target="_blank" title="PACE Waiver Memo April 4, 2015">PACE Waiver Memo_April, 2015</a><br /><br /><a href="/pacemailbox/S3Browser/GetFile?path=Clarification%20on%20the%20Requirements%20for%20Alternative%20Care%20Settings%20in%20the%20PACE_June%2030%2C%202016.pdf" target="_blank">Clarification on the Requirements for Alternative Care Settings in the PACE_June 30, 2016</a><br /><br /><a href="/pacemailbox/S3Browser/GetFile?path=PACE%20Windsor%20memorandum.pdf" re_target="_blank" target="_blank" title="US vs. Windsor on PACE Memo">US vs. Windsor on PACE Memo</a><br /><br /><a href="/pacemailbox/S3Browser/GetFile?path=PACE%20Marketing%20Guidelines%2010_2_2018.pdf">PACE Marketing Guidelines 10_2_2018</a><br /><br /><a href="/pacemailbox/S3Browser/GetFile?path=PACE%20Quality%20Monitoring%20Module%20Industry%20Training%20March%2022%202018.pdf">PACE Quality Monitoring Module &amp; Industry Training, March 2018</a><br /><br /><a href="/pacemailbox/S3Browser/GetFile?path=PACE%20Quality%20Monitoring%20and%20Reporting%20FAQs%20April%202018.pdf">PACE Quality Monitoring and Reporting FAQs,_April 2018</a><br /><br /><a href="/pacemailbox/S3Browser/GetFile?path=2018%20HPMS%20PACE%20Quality%20Monitoring%20-%20Quality%20Data%20Selection%20Values.pdf">2018 HPMS PACE Quality Monitoring - Quality Data Selection Values</a><br /><br /><a href="/pacemailbox/S3Browser/GetFile?path=PACE%20Quality%20Monitoring%20and%20Reporting%20Guidance%20January%202024.pdf" target="_new">PACE Quality Data Monitoring &amp; Reporting Guidance, January 2024</a></p><p><a href="/DMAOMailbox/Documents/CostPlanExpansionMissingTemplateError.pdf"></a></p></div></div>

CY 2020 Advance Notice and Call Letter April 1, 2019

2018 PACE Application Guidance and Training Announcement

Overview of the PACE Application Process_February 7, 2018

HPMS ePace_Application_Training_February 7, 2018

PACE Regulation

PACE Manual System

NP and CB PCP Waiver Checklist_April 17, 2015

New Quarterly Submission Process of Waivers for PACE Organizations_October 30, 2017

PACE Waiver Memo_April, 2015

Clarification on the Requirements for Alternative Care Settings in the PACE_June 30, 2016

US vs. Windsor on PACE Memo

PACE Marketing Guidelines 10_2_2018

PACE Quality Monitoring Module & Industry Training, March 2018

PACE Quality Monitoring and Reporting FAQs,_April 2018

2018 HPMS PACE Quality Monitoring - Quality Data Selection Values

PACE Quality Data Monitoring & Reporting Guidance, January 2024

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Answers to previously asked questions

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PACE Portal FAQs (November 2015)

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Following are available resources if your questions do not relate to PACE

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<div id="detailsContainer"><div class="ma-details-row"><p>Questions specifically related to the Medicare FFS Average Sales Price (ASP) files may be directed to: <a href="mailto:Sec303ASPdata@cms.hhs.gov">Sec303ASPdata@cms.hhs.gov</a></p><div class="ma-details-row"><p>If your question is regarding the Inflation Reduction Act, please submit the question to:&nbsp;<a href="mailto:IRARebateandNegotiation@cms.hhs.gov">IRARebateandNegotiation@cms.hhs.gov</a>&nbsp;</p></div><div class="ma-details-row"><p>Policy related fiscal soundness questions, please submit an e-mail to:&nbsp;<a href="mailto:FinancialReview@cms.hhs.gov&gt;FinancialReview@cms.hhs.gov&lt;/a&gt; &lt;/p&gt; &lt;p&gt;Technical HPMS questions (e.g., PBP download, plan creation, bid upload), please contact the HPMS Help Desk at 1-800-220-2028 or &lt;a href=">FinancialReview@cms.hhs.gov</a></p></div><div class="ma-details-row"><p>Technical questions about the Out-of-Pocket Cost (OOPC) model, please submit an email to:&nbsp;<a href="mailto:OOPC@cms.hhs.gov?subject=Technical OOPC questions">OOPC@cms.hhs.gov</a> </p></div><div class="ma-details-row"><p>Part D benefits questions, please submit an email to:&nbsp;<a href="mailto:partdbenefits@cms.hhs.gov?subject=Part D Benefit question">partdbenefits@cms.hhs.gov</a><br /></p></div><div class="ma-details-row"><p>Bid Pricing Tool (BPT) questions, please submit an email to:&nbsp;<a href="mailto:actuarial-bids@cms.hhs.gov">actuarial-bids@cms.hhs.gov</a></p></div><div class="ma-details-row"><p>Medicare Medicaid Program,&nbsp;please submit an email to:&nbsp;<a href="mailto:mmcocapsmodel@cms.hhs.gov">mmcocapsmodel@cms.hhs.gov</a></p></div><div class="ma-details-row"><p>Part C Medicare Advantage policy questions, please submit an inquiry via:&nbsp;<a href="https://dpap.lmi.org/DPAPMailbox/">https://dpap.lmi.org/DPAPMailbox/</a> <a href="https://dpap.lmi.org/DPAPMailbox/"></a></p></div><div class="ma-details-row"><p>Medicare Advantage Value-Based Insurance Design (MA-VBID) model questions, please submit an e-mail to:&nbsp;<a href="mailto:VBID@cms.hhs.gov">VBID@cms.hhs.gov</a></p></div><div class="ma-details-row"><p>Risk adjustment questions can be directed to <a href="mailto:riskadjustmentoperations@cms.hhs.gov" tabindex="-1" target="_blank" title="riskadjustmentoperations@cms.hhs.gov"><span>riskadjustmentoperations@cms.hhs.gov</span></a></p></div><div class="ma-details-row"><p>Appeals Policy questions, please submit inquiry via: <a href="https://appeals.lmi.org/" target="_blank" title="https://appeals.lmi.org/">https://appeals.lmi.org/</a></p></div><div class="ma-details-row"><p>Enrollment and Eligibility Policy questions, please submit inquiry via: <a href="https://enrollment.lmi.org/" tabindex="-1" target="_blank" title="https://enrollment.lmi.org"><span>https://enrollment.lmi.org</span></a></p></div></div></div>

Questions specifically related to the Medicare FFS Average Sales Price (ASP) files may be directed to: Sec303ASPdata@cms.hhs.gov

If your question is regarding the Inflation Reduction Act, please submit the question to: IRARebateandNegotiation@cms.hhs.gov

Policy related fiscal soundness questions, please submit an e-mail to: FinancialReview@cms.hhs.gov

Technical questions about the Out-of-Pocket Cost (OOPC) model, please submit an email to: OOPC@cms.hhs.gov

Part D benefits questions, please submit an email to: partdbenefits@cms.hhs.gov

Bid Pricing Tool (BPT) questions, please submit an email to: actuarial-bids@cms.hhs.gov

Medicare Medicaid Program, please submit an email to: mmcocapsmodel@cms.hhs.gov

Part C Medicare Advantage policy questions, please submit an inquiry via: https://dpap.lmi.org/DPAPMailbox/

Medicare Advantage Value-Based Insurance Design (MA-VBID) model questions, please submit an e-mail to: VBID@cms.hhs.gov

Risk adjustment questions can be directed to riskadjustmentoperations@cms.hhs.gov

Appeals Policy questions, please submit inquiry via: https://appeals.lmi.org/

Enrollment and Eligibility Policy questions, please submit inquiry via: https://enrollment.lmi.org

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PACE Question

Please review the available guidance documents and resources described above before submitting a question.

Division of Medicare Advantage Operations

Programs of All-Inclusive Care for the Elderly

Guidance resources for Division of Medicare Advantage Operations (DMAO)Programs of All-Inclusive Care for the Elderly (PACE)

Guidance

Questions & Answers

Resources

Please review the available guidance documents and the resources below that may answer your question.

Answers to previously asked questions

Following are available resources if your questions do not relate to PACE

PACE Question

Guidance resources for Division of Medicare Advantage Operations (DMAO)
Programs of All-Inclusive Care for the Elderly (PACE)