Advancing Access to Quality Care: Intus Care Supports Key PACE Legislation

The Intus Care team had the opportunity to attend the National PACE Association’s (NPA) Spring Policy Forum last week, learning about and discussing issues and trends impacting the PACE model of care. Among the topics that drove discussion over the two days in Washington, D.C., NPA highlighted five bills that are currently moving through Congress, advocating for their passage.

As a prominent technology company dedicated to transforming healthcare delivery, Intus Care wholeheartedly supports legislative measures aimed at substantially improving access to comprehensive services for our esteemed PACE partners and the participants they support.

PACE Part D Choice Act

This bill would remove a major financial barrier preventing many Medicare beneficiaries from enrolling in PACE. Currently, Medicare-only beneficiaries who want to participate in PACE must enroll in their PACE provider’s Part D prescription drug plan with premiums reaching upwards of $1,100 per month. By comparison, standalone Part D plans have average premiums of $48. This cost differential makes PACE inaccessible to many Medicare-only beneficiaries who could benefit from the comprehensive, community-based care model.

The PACE Part D Choice Act would give Medicare-only beneficiaries the opportunity to opt for either a standalone Part D plan or the PACE organization’s Part D plan, depending on the participant’s unique needs and circumstances. This could open access to PACE program’s quality care to thousands of older adults that can’t afford it with the current model. By giving options that would lower the monthly cost, the bill allows more people the option to access enhanced care as an alternative to nursing home placement.  

Senator Elizabeth Dole 21^st Century Veterans Healthcare and Benefits Improvement Act

At Intus Care, we recognize and honor the sacrifices made by our nation’s veterans. The Senator Elizabeth Dole 21^st Century Veterans Healthcare and Benefits Improvement Act embodies a multifaceted approach to enhancing veterans' access to critical healthcare services, including home- and community-based care (HCBS) such as PACE.  

Currently, whether veterans can access PACE and other HCBS options depends entirely on where they live, and the availability determined by their local VA Medical Center. This legislation would require any VAMC located near a PACE provider to partner with that organization, giving more veterans the choice to receive comprehensive care and services in their homes and communities as an alternative to nursing homes.

By empowering veterans to make informed choices about their care, this bill fosters autonomy, dignity, and quality of life for those who have served our country. At Intus Care, we have seen firsthand how transformative the PACE model of care can be in allowing participants to age in place while receiving fully integrated medical and supportive services. We believe all older Americans, including our honored veterans, deserve access to this quality, person-centered care option.

Delivering Unified Access to Lifesaving Services Act (DUALS Act)

The Delivering United Access to Lifesaving Services (DUALS) Act of 2024 is designed to help increase access to PACE programs for individuals who are known as “dual eligibles,” in that they have insurance coverage through both Medicare and Medicaid.

According to the National PACE Association (NPA), the bill would expand access to PACE by:

• Requiring all states to offer PACE to eligible individuals.
• Allowing PACE organizations to enroll participants any time rather than just on the first of the month.
• Extending PACE eligibility to Medicare-eligible individuals under 55.
• Removing quarterly restrictions for submission of both new and expanding PACE organization applications.
• Ensuring that Medicare-only PACE program enrollees have a choice of prescription drug plans under Medicare part D.

HCBS Relief Act

The HCBS Relief Act would give states a 10 percentage-point increase in their Federal Medical Assistance Percentage (FMAP) for Medicaid to enhance home- and community-based services (HCBS). The additional funds could be used to increase direct care worker pay, provide benefits such as paid family leave or sick leave, and pay for transportation expenses to and from the homes of those being served.

PACE programs provide care to individuals on Medicaid from their homes, so the funding could potentially benefit PACE organizations by enhancing their ability to provide comprehensive care and support services to elderly individuals.

PACE Expanded Act

The PACE Expanded Act aims to support the expansion of existing PACE programs and facilitate the establishment of new ones. It allows Medicare beneficiaries to access PACE services without the need to meet certain nursing home level-of-care requirements, easing eligibility.

This legislation is intended to spur growth in PACE organizations, increasing seniors' access to medical care and long-term care services to improve healthcare outcomes and enhance quality of life for older Americans.

Advocate for Support of These Legislative Initiatives

Intus Care affirms its support for these legislative efforts that will increase access to PACE programs nationwide, including our valued PACE partners. If these bills successfully pass, PACE organizations will be better able to deliver holistic, person-centered care and impact more individuals and their families. Call your local representatives in Congress to show your support and help push for these bills to pass. Find your members.

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