PACE Benefit Table

Program of All-Inclusive Care for the Elderly (PACE) Benefit Table

The Program of All-Inclusive Care for the Elderly (PACE) is administered by MO HealthNet and Medicare to provide comprehensive health care, social, recreational, and wellness services to its participants. One of the main goals of PACE is to allow older adults to live safely in their homes instead of nursing facilities. As of May 3, 2024, PACE organizations are active in St. Louis and Kansas City, with a new PACE organization coming to the Springfield area later this year.

Consumer Directed Services Manager Requirement

Consumer Directed Services Manager Requirement

Per the updated Consumer Directed Services (CDS) regulation 19 CSR 15-8.400(1)(D), all CDS providers are required to have a Certified CDS Manager. This CDS Manager is required to pass Certified CDS Manager Test administered by Missouri Medicaid Audit and Compliance (MMAC). All currently enrolled CDS providers will be required to be compliant by December 31, 2024. For more information, review the MMAC Post.

Financial Management Services (FMS)

This Hot Tip serves as a reminder that in order for an Independent Living Waiver (ILW) provider to be reimbursed for Financial Management Services (FMS), the provider must be enrolled as a MO HealthNet Consumer-Directed Services (CDS) provider and complete a MO HealthNet FMS addendum. MO HealthNet continues to see claims deny for ILW providers billing for FMS, as some providers do not have the required FMS addendum on their provider enrollment file.