HB2665 - 104th General Assembly

DHFS-PACE-RATE REFORM
Last Action

3/21/2025 - House: Rule 19(a) / Re-referred to Rules Committee
House Sponsors

Rep. Thaddeus Jones and Camille Y. Lilly
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
2/04/2025 House Filed with the Clerk by Rep. Thaddeus Jones
2/06/2025 House First Reading
2/06/2025 House Referred to Rules Committee
3/04/2025 House Assigned to Appropriations-Health and Human Services Committee
3/21/2025 House Rule 19(a) / Re-referred to Rules Committee
4/10/2025 House Added Co-Sponsor Rep. Camille Y. Lilly