CMS Fines Three PACE Organizations for Service and Documentation Failures

CMS recently imposed fines on three PACE organizations—Suncoast PACE, LIFE Northwestern Pennsylvania, and Beacon Care Ventures—for not meeting critical program requirements. The deficiencies identified include inadequate service provision, poor tracking and documentation of services, and failure to ensure services recommended by specialists were provided or properly documented. Each organization faces a fine of $47,596 and must request a hearing by June 11 if they wish to contest the penalties.

Suncoast PACE and LIFE Northwestern Pennsylvania audits found non-compliance between January and March 2024, involving gaps in service delivery and documentation. Beacon Care Ventures' violations, identified in an audit covering July to August 2024, included failure to provide ordered services such as specialist consultations, diagnostic tests, homecare, and medications, in addition to inadequate monitoring across care settings. These enforcement actions underscore CMS's focus on compliance, program integrity, and quality assurance within managed care arrangements for vulnerable populations.