On July 24, LeadingAge and the National PACE Association sent a joint letter urging CMS Administrator Chiquita Brooks-LaSure to include stricter marketing rules for Medicare Advantage (MA) plans and improve transparency for PACE participants when they are disenrolling from PACE programs in the CY ’26 Medicare policy and technical rule, which is anticipated in September.
LeadingAge has heard extensively from PACE members that MA plans are enticing participants out of PACE programs and into MA plans with the allure of cash cards to assist with groceries, utilities, rent, or other needs of a family. However, the MA plans are not so forthcoming about the PACE benefits that will be lost when these individuals shift to the MA plan with the cash card.
PACE participants are also not informed by the MA plan that transportation benefits under the plan are for group or rideshare transportation not appropriate for an individual needing wheelchair accessible transportation. In the letter, LeadingAge reminds CMS that MA plan inducement of duals from PACE to MA plans is counter to CMS’ own goal of increasing enrollment in integrated products for individuals dually eligible for Medicare and Medicaid. Review the letter here.