PACE Expansion Application
Guidance for PACE organizations wishing to expand their service area or add a new PACE center
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: March 05, 2012
The PACE Expansion Application (updated October 2004), available using the link below, is required for PACE organizations wishing to expand their service area or add a new PACE center. There are three scenarios under which a PACE provider may expand operations. Each scenario described below 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.
· PACE Organization (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.
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