SB1804 - 104th General Assembly

DHFS-PACE-RATE REFORM
Last Action
6/02/2025 - Senate: Rule 3-9(a) / Re-referred to Assignments
Senate Sponsors
Sen. Ram Villivalam
Statutes Amended In Order of Appearance
Synopsis As Introduced
Amends the Program of All-Inclusive Care for the Elderly Act. Provides that to ensure that organizations contracted to implement the Program of All-Inclusive Care for the Elderly (PACE) program meet the needs of PACE participants, the Department of Healthcare and Family Services shall reform the rate-setting methodology for the PACE program by establishing a blended rate structure based on a 30% Home and Community-Based Services and 70% Skilled Nursing Facility case-mix which is a more accurate proportion of the comparable population expected to reside in an institution or the community if not enrolled in PACE. Requires the blended rate structure to more accurately reflect the comprehensive nature of care provided by PACE organizations and address the unique needs of PACE participants as a higher risk/acuity population with expected higher costs and frailty than comparable populations. Provides that when developing rates under the blended rate structure, the Department must consider not only the standard cost experiences of PACE participants but also the unique characteristics and specific care needs of the PACE population as well as any additional State plan services or populations that are not included in the State's Medicaid managed care contracts but are required under the PACE program.
Actions
Date Chamber Action
2/06/2025 Senate Filed with Secretary by Sen. Ram Villivalam
2/06/2025 Senate First Reading
2/06/2025 Senate Referred to Assignments
2/18/2025 Senate Assigned to Appropriations- Health and Human Services
3/21/2025 Senate Rule 2-10 Committee Deadline Established As April 11, 2025
4/11/2025 Senate Rule 2-10 Committee Deadline Established As May 9, 2025
5/09/2025 Senate Rule 2-10 Committee/3rd Reading Deadline Established As May 23, 2025
5/23/2025 Senate Rule 2-10 Committee/3rd Reading Deadline Established As June 1, 2025
6/02/2025 Senate Rule 3-9(a) / Re-referred to Assignments