The bill removes organizations providing a program of all-inclusive care for the elderly (PACE) from licensure by the department of public health and environment as home care agencies.
The bill requires the department of health care policy and financing (department) staff, the single entry point system staff, county department staff, and PACE program staff to fully inform an eligible person, prior to enrolling the person in an accountable care organization or collaborative, a managed care organization, or other risk-bearing entity that serves medicaid or medicaid-eligible beneficiaries, about the benefits available through the PACE program in the area where the eligible person resides and that PACE enrollment is an option for the eligible person. The medical services board (board) is required to adopt rules regarding these requirements.
The term "eligible person", for purposes of the PACE program, is amended to include dually eligible persons. A "dually eligible person" is defined as a person who is eligible for assistance or benefits under both medicaid and medicare. The bill also defines "accountable care organization or collaborative" and "regional care collaborative organization".
An eligible person who is enrolled in an accountable care organization or collaborative, a managed care organization, or other risk-bearing entity may elect to withdraw from or terminate such enrollment and enroll in and receive services from a PACE program. The board's rules shall define how such election is made.
The department shall provide quarterly to each PACE provider a list of all eligible persons residing in the area served by such PACE provider who have not elected to participate in the PACE program.