PACE program marketing: what 42 CFR 460.82 and the CMS guidelines mean for your website, events and outreach

PACE, the Programs of All-Inclusive Care for the Elderly, is a program where marketing information goes to CMS and the state for approval before the public sees it. The rule is 42 CFR 460.82, and CMS explains how it applies in the PACE Marketing Guidelines, Chapter 3 of the PACE Manual, linked from the CMS PACE page. This guide reads both from the side of the people who build the website, run the ads, staff the events and answer the phones.

Several related topics have their own guides and are not repeated here. Gifts and offers to Medicare patients in general are covered in marketing to Medicare patients, and the beneficiary notice rules for Shared Savings Program practices in ACO marketing rules. Marketing a residential setting for older adults is covered in assisted living marketing ideas, and consent for patient stories in patient testimonials and before and after photos.

What counts as PACE marketing

Section 460.82(a)(1) says a PACE organization must inform the public about its program, and the guidelines define marketing materials as information a PACE organization provides to the public about its program, which must be approved by CMS and the state administering agency. That covers brochures, enrollment kits, web pages, hold messages that promote the program or describe benefits, and materials a subcontractor creates on the organization’s behalf.

Timing matters before a single ad runs. The guidelines say an organization may not begin marketing until its initial application has been approved and it has received its signed PACE program agreement, and may not market new PACE centers or service areas until it receives the amended, signed agreement. A website for a new center that is still waiting on that amendment should stay unpublished, even if the building is ready.

Section 460.6 defines a PACE center as a facility that includes a primary care clinic and areas for therapeutic recreation, restorative therapies, socialization, personal care and dining. If you also run an alternative care setting, section 50.5 of the guidelines says your marketing must make clear that it is not a PACE center and offers a more limited set of services.

How CMS and state review works

Section 460.82(b)(1) says CMS must approve all marketing information before distribution, including revised or updated material. Once an organization is under a program agreement, section 460.82(b)(3) gives CMS 45 days to approve or disapprove, and material is deemed approved if CMS and the state administering agency do not disapprove it within that period. The guidelines describe submission through the marketing module in HPMS, with both a CMS and a state reviewer selected, and statuses of approved, disapproved, withdrawn, alternate format or deemed.

Three practical rules from the guidelines shape production schedules:

• Every material carries a unique marketing material ID made of the contract number and characters the organization chooses. ID cards, radio ads and social media comments and posts do not need one.
• A template can be submitted once with bracketed placeholders, such as the center name, address, phone number or URL, and keeps one ID for every combination.
• CMS keeps the right to disapprove a previously approved material if it is later found to be inaccurate, altered or otherwise out of line with the rules.

Section 80 of the guidelines lists materials that are not submitted for review, such as banner and banner-like ads, outdoor advertising, press releases with no PACE-specific information, general health education with no organization-specific information, and newsletters to professional referral sources. The organization still has to meet the rules for them and keep a system to track them so they can be produced if CMS asks. Once a billboard adds benefit or premium details, it is no longer just a name and a phone number.

Websites have their own process. Section 30.4.3 says website content must be submitted for review, with the organization’s own material ID and date stamp on updated pages. An approved organization may publish during the review period if it indicates that the website is pending CMS review, and if pages are disapproved it must submit a revised version within 20 calendar days or remove the disapproved content from public view.

What your materials have to say

Section 460.82(a)(1) lists the written information prospective participants must receive: an adequate description of enrollment and disenrollment policies and requirements, enrollment procedures, a description of benefits and services, premiums, and other information they need to make an informed decision. The guidelines say not every piece has to include all of it, as long as the full set of materials a prospective participant receives does.

Two statements are different. Section 460.82(d)(1) requires marketing materials to tell a potential participant that they must receive all needed health care, including primary care and specialist physician services other than emergency services, from the PACE organization or an entity it authorizes. Section 460.82(d)(2) says all marketing materials must state clearly that participants may be fully and personally liable for the costs of unauthorized or out-of-PACE program agreement services. Build both into every template, not just the enrollment kit.

Premium wording is where loose copy causes trouble. The guidelines give sample language: if you are eligible for Medicaid, or dually eligible for Medicare and Medicaid, you will not pay a monthly premium for PACE; if you have Medicare but not Medicaid, you will be charged a monthly premium; there is no deductible or copayment for any drug, service or care approved by your health care team; and without Medicare or Medicaid you can pay privately. A headline that calls PACE free without those conditions leaves out the part a Medicare-only family needs.

Eligibility copy should follow section 460.150: age 55 or older, a determination by the state administering agency that the person needs the level of care required for nursing facility services under the State Medicaid plan, residence in the service area, and the ability at enrollment to live in a community setting without jeopardizing their health or safety. The state makes the level of care determination, not your intake team or your ad, so write “you may qualify” and explain who decides. Medicare.gov says PACE is not available in all states, so a national-looking page should name the service area plainly.

Section 460.162(b) says a participant may voluntarily disenroll without cause at any time. That is a fair point to make in plain language, and the website requirements below ask for participant rights and responsibilities on disenrollment.

Website requirements

Section 70.1 of the guidelines says that if a PACE organization has a website, including a parent company site with PACE content, it must meet all of the marketing requirements and the accessibility standards for people with disabilities, including Section 508 of the Rehabilitation Act. It also lists what the site must include:

• A separate and distinct section for PACE if the site covers other lines of business, and a notice when a link leaves the PACE section or the site.
• Clearly labelled links and a date stamp on each page with the date it was last updated.
• The toll-free customer service number and hours of operation, a TTY number, and a physical or post office box address.
• Participant rights and responsibilities upon disenrollment, and the service area.
• A statement that PACE will be the participant’s sole service provider and that the organization “guarantees access to services, but not to a specific provider”.
• Instructions on appointing a representative, with a link to the downloadable CMS Form 1696.
• How participants, family members or representatives file a grievance and an appeal, with phone, mailing address, fax, any forms and contact numbers for status questions.

Two of those are easy to miss in a redesign: the per-page date stamp and the exit notice on links. If your site runs on templates, put both in the template so that a new page cannot ship without them. Our website accessibility guide covers the accessibility side in more detail.

Claims, data and testimonials

Section 460.82(a)(2) requires marketing information to be free of material inaccuracies, misleading information or misrepresentations, and section 460.82(e)(2) prohibits activities that could mislead or confuse potential participants or misrepresent the PACE organization, CMS or the state administering agency. Section 50.3 of the guidelines turns that into specific limits. An organization may say it is approved to participate in Medicare and Medicaid and may use the terms Medicare covered or Medicaid covered. It must not claim to be recommended or endorsed by HHS, CMS or Medicare, or use their names and logos in a way that suggests approval or endorsement. Absolute or qualified superlatives such as “the best” or “one of the best” need supporting data provided to CMS during review, unless they sit in a logo or tagline.

Section 50.2 says any material that uses studies, statistical data or survey results about satisfaction, quality or cost must name the sponsoring organization, describe your relationship with whoever conducted the study, and give the publication title, date and page number. A satisfaction percentage on a landing page is a statistic, and it needs that footnote.

Section 50.4 sets the testimonial rules:

• The person giving the testimonial must identify the PACE organization by name.
• A participant must be enrolled when the testimonial is created, and the organization is responsible for securing consent to use their statements and images.
• Family members and caregivers may give testimonials, including about a participant who has died, if they reference a time when the participant was enrolled.
• No fictitious quotes by physicians or other health care providers.
• Paid testimonials and paid actor portrayals must be disclosed as such.

The guidelines also treat re-publishing someone’s social media comment that promotes the organization as an endorsement or testimonial. Sharing a family’s post on your own page brings it under the same rules.

Outreach and lead generation

This section is where PACE marketing departs from ordinary practice marketing. Section 460.82(e)(5) prohibits unsolicited door-to-door marketing or other unsolicited means of direct contact, including calling or emailing a potential or current participant without the individual initiating the contact. Section 60.1 of the guidelines adds that organizations must not call former participants or participants in the process of disenrolling to re-enroll or retain them, must not call people who attended a marketing or informational event unless they gave explicit permission at the event, and must not advertise outside the service area unless that is unavoidable, in which case the service area should be clearly disclosed.

What the guidelines allow is narrower than a typical lead program but workable. An organization may return phone calls and messages from prospective participants, family members and caregivers, call people who gave explicit permission, and make an initial follow-up call or mailing based on a referral from family, friends, neighbors or community partners such as social workers, physician offices and housing managers. If the person shows no interest on that first contact, the guidelines say further contact is prohibited. A web form should therefore record who asked to be contacted, how, and about what, and your call notes should record a “no interest” answer so no one follows up again.

Section 460.82(e)(4) prohibits marketing by anyone compensated directly or indirectly based on activities or outcomes unless they have been trained on PACE program requirements, makes the organization responsible for contracted marketers, and requires a method to document that training. Section 60.2 of the guidelines also bars third parties whose sole responsibility is to directly contact prospective participants to solicit enrollment, while allowing subcontracted administrative work such as printing and web development. In practice that rules out buying leads from a call center that dials prospects, and it means any agency that touches your marketing should be on your training log.

Gifts, events and drawings

Section 460.82(e)(3) prohibits gifts or payments to induce enrollment unless they are of nominal value as defined in CMS guidance, offered to all potential enrollees whether or not they enroll, and not cash or monetary rebates. Section 60.3 of the guidelines sets nominal value at 15 dollars or less retail per item, with a maximum aggregate of 75 dollars per person per year, and says gift cards and certificates that can be readily converted to cash count as cash regardless of amount.

For a single large gift such as a concert or raffle, the guidelines say the total retail value must not exceed the per-person nominal value multiplied by anticipated attendance, which must be based on venue size, response rate or ad circulation. Section 60.4 requires a written statement on any material promoting drawings, prizes or a free gift that there is no obligation to enroll. Our patient education seminar guide covers running the event itself.

Language, format and accessibility

Section 460.82(c) requires printed marketing materials in English and in any other principal languages of the community as determined by the state, and where the state has no standard, any language spoken in the home by at least 5 percent of the individuals in the service area. Materials must be available in Braille if necessary. The guidelines add interpreter services, alternate formats such as large print and audio, and a font size rule: text, including footnotes, at a size equivalent to or larger than 12-point Times New Roman, with exceptions such as television ads, logos with taglines and media where the organization does not control font size.

Section 40.5 says a TTY number must appear in the same font, size and style as the other telephone numbers wherever the customer service number is listed, and must be toll-free. Outdoor and banner-like ads and radio ads are exempt. On a website, that means the TTY number belongs next to the main number in the header or footer, not on a separate contact page.

Illustration: two campaigns, one rule set

Illustration: a PACE organization plans a fall campaign with a refreshed website, a mailer and a family information session. The marketing team builds the web pages and mailer from approved templates with material IDs, adds the restriction of services and liability statements to both, includes the premium wording for Medicaid and Medicare-only families, and submits everything in HPMS 45 days before the mailer drops. The event invitation states that the raffle carries no obligation to enroll, the raffle value is set from the room capacity, and the sign-in sheet asks attendees whether they want a follow-up call. Only those who tick yes are called.

Illustration: the same organization is offered a lead package by a vendor that would phone older adults in the service area and transfer interested ones to intake, paid per transfer. Under section 460.82(e)(5) and section 60.2 of the guidelines, that is unsolicited direct contact by a third party whose job is to solicit enrollment, and the organization declines. It spends the budget instead on search ads limited to its service area, a landing page that names the service area, and education for referral sources such as social workers and physician offices.

Checklist

• No marketing starts before the signed program agreement, and no new center or service area is marketed before the amended agreement.
• Every material subject to review has a material ID and was submitted in HPMS to CMS and the state.
• Every template includes the restriction of services statement and the personal liability statement.
• Premium copy separates Medicaid, Medicare-only and private pay, and never calls PACE free without those conditions.
• Eligibility copy lists the four conditions and says the state determines the level of care.
• The website has a PACE section, exit notices, page date stamps, toll-free and TTY numbers, hours, address, service area, disenrollment rights, sole provider statement, Form 1696 link and grievance and appeal details.
• Pages under review carry a pending CMS review notice, and disapproved pages are revised within 20 calendar days or taken down.
• Studies and statistics carry the sponsor, relationship and publication details.
• Testimonials name the organization, come from enrolled participants or family referencing enrollment, have consent on file and disclose payment.
• No unsolicited calls, emails or door-to-door visits, event follow-up only with explicit permission, and a single follow-up on referrals.
• Anyone paid on activities or outcomes has documented PACE training.
• Gifts stay within nominal value, are never cash or cash-convertible, and promotions state there is no obligation to enroll.
• Printed materials exist in the state’s principal languages, and alternate formats are ready on request.

How we help

We build websites, local search, Google Ads and AI front desk tools for independent practices and health businesses. For a PACE organization, we can build website templates with the date stamps, exit notices, TTY numbers and required statements in place, keep a log of material IDs and review status for each page, and set up inquiry and referral intake that records who asked to be contacted and stops follow-up when someone says no. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it. We do not sell lead lists and we do not pay for referrals. For the wider rules, see our healthcare marketing rules hub.

Sources

• 42 CFR part 460: Programs of All-Inclusive Care for the Elderly (PACE)
• CMS: Program of All-Inclusive Care for the Elderly (page last modified March 16, 2026)
• CMS: PACE Manual Chapter 3, Marketing Guidelines (Rev. 5, issued October 2, 2018)
• Medicare.gov: PACE
• CMS Form 1696: Appointment of Representative

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