Initial applicants and existing PACE organizations seeking to expand a geographic service area and/or open a new PACE center must submit their applications electronically through the CMS Health Plan Management System (HPMS). The initial and Service Area Expansion (SAE) applications are largely attestation-based, accompanied by a series of uploaded documents as specified in the application. 

Critical deadlines for applications submitted in 2019 are included in the Jan. 31, 2019, guidance listed below. 

Refer to the following resources for a complete explanation of the initial and SAE application process and requirements:

  • PACE Organization Initial Application: This is a requirement for new PACE organizations.
  • PACE Part D Application: The Medicare Part D application is required for new PACE organizations. CMS requires this application be submitted with the PACE organization initial application.
  • PACE Organization SAE Application: The Service Area Expansion (SAE) application is required for existing PACE organizations seeking to expand their geographic service area, add a new PACE center (with the exception of adding a new PACE center that will replace an existing PACE center, for which there is separate guidance), or both.
  • CMS 2019 PACE Application Guidance (1/31/19): This CMS memo announces instructions for submitting initial and SAE applications in 2019. The 2019 deadlines related to submitting both initial and SAE applications are included. For initial applicants, the application timeline includes submission of a Notice of Intent to Apply (NOIA) and a request for access to the CMS Health Plan Management System (HPMS), which is needed to submit the application electronically through HPMS.
  • Overview of the PACE Application Process (2/6/19): This CMS PowerPoint presentation provides information on the automated PACE application processes for both initial and SAE applications, including information on submitting a Notice of Intent to Apply and accessing HPMS for initial applicants. Critical time frames and application submission deadlines also are included.
  • HPMS PACE Automated Application Training (2/6/19): This CMS PowerPoint presentation provides important information on how to submit the PACE provider and Part D applications via HPMS.

Note: The information provided here is specific to the CMS application process. The state application process for PACE varies by state. Applicants should work closely with their state to ensure state application requirements for PACE are followed. Applicants must be prepared to include a State Assurance with the application as required by CMS. 

For more information, contact Chris van Reenen.

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