What the PACE Access Improvement Act Could Mean for Home Care Agencies

A bill introduced in the House on September 24 could reshape a long-running home-and-community care model in Medicare and Medicaid. The PACE Access Improvement Act (H.R. 10547), from Michigan Reps. Debbie Dingell and John Moolenaar, would make the Program of All-Inclusive Care for the Elderly a mandatory Medicaid service, let enrollment start any day of the month, and ease how PACE organizations apply to open or expand. For agencies that send caregivers and clinicians into homes every day, it is worth understanding now, even though it is early.

Here is what the bill would actually change, based on the bill text and coverage from Home Health Care News and LeadingAge. Today, PACE enrollment takes effect on the first day of the following month, so a participant who qualifies on the 3rd can wait weeks for coverage. The bill would allow enrollment to take effect at any time. It would shift PACE from optional to mandatory across states; according to the National PACE Association, 33 states and Washington, D.C. offer it today across 204 locations. States that already have a PACE provider would have 180 days after enactment to comply, and states without one would have three years. The bill would also streamline the CMS application and expansion process and allow limited marketing before final CMS approval, so a new program can build awareness before it opens.

What the PACE Access Improvement Act means for home care operations

Keep expectations grounded. The bill was referred to the Energy and Commerce and Ways and Means committees, and LeadingAge, which supports it, says passage before the end of 2026 is unlikely, with a Senate companion expected later this year. Still, the direction matters. PACE bundles medical and social services so older adults who meet a nursing home level of care can stay at home, and in-home support is part of that model. If more states must offer PACE and programs can grow faster, more local PACE organizations may look for dependable in-home partners. Rep. Dingell framed it plainly: too many Americans still sit on waitlists for home and community-based services.

A practical step this quarter is to learn who runs PACE in your service area, whether your state offers it, and how those programs work with outside home care providers. An integrated program that answers for a full care plan will usually ask partners to show what was scheduled and what actually happened. That is where clean records help. CareSync® gives teams planned-versus-completed visit visibility on one board, which is the kind of plain proof any partner conversation tends to start with. Nothing here needs a sales pitch, only a clear picture of your own visit history.

Follow the bill through committee and watch for the Senate version. If the PACE Access Improvement Act moves, the agencies best placed to benefit will be the ones that already know their local PACE landscape and can show their work.