On April 11, CMS fined three PACE organizations for failing to meet essential program requirements, including inadequate service provision, poor tracking and documentation of services, and failure to ensure recommended services were either provided or properly documented with valid reasons for non-provision.
Each company has until June 11 to request a hearing.
1. Suncoast PACE was fined $47,596 after an audit of its operations from March 4, 2024, to March 18, 2024, found that the organization had failed to comply with essential program conditions, including failing to provide services that met the needs of participants, not properly tracking or documenting the provision of services, and not ensuring services recommended by specialists were either provided or documented with valid reasons for non-provision.
2. LIFE Northwestern Pennsylvania was fined $47,596 after an audit of its operations from January 8, 2024, to January 22, 2024, found that the organization did not provide necessary services to participants, failed to properly track or document the provision of these services, and did not ensure that services recommended by specialists were either provided or documented with valid reasons for non-provision.
3. Beacon Care Ventures, operating as BoldAge PACE, was fined $47,596 after a CMS audit found that the organization failed to meet several PACE program requirements from July 22, 2024, to August 2, 2024. BoldAge was found to have not provided services adequate to meet the needs of participants, and failed to track, document, and monitor services across care settings as required. The audit revealed that services recommended by employees or specialists were not provided, nor were reasons documented for non-provision. Additionally, services such as specialist consults, diagnostic tests, homecare, and medications were not delivered as ordered.
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