PACE Notification

Please complete the following form to notify the Division of Care Management of a beneficiary's enrollment/disenrollment to the PACE program.

Submitter Information
Beneficiary Information
Enrollment Information
Files must be less than 5 MB.
Allowed file types: pdf.
Disenrollment Information
Files must be less than 5 MB.
Allowed file types: pdf.

Please submit any questions to PACE@scdhhs.gov

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