Senate Bill 16-199 Summary

• Establishes a State PACE Ombudsman office within the existing long-term care ombudsman program to investigate and resolve complaints from Program of All-Inclusive Care for the Elderly (PACE) participants.

• Requires PACE programs to post notices informing participants of the ombudsman's contact information and provides the ombudsman immediate access to PACE facilities and participant records.

• Prohibits discriminatory, disciplinary, or retaliatory action against PACE participants or employees who communicate with the ombudsman, with enforcement authority granted to the Department of Human Services.

• Directs the state health care policy and financing department to develop an actuarially sound upper payment limit methodology for PACE capitated rates, with a minimum percentage floor until the methodology is adopted in state board rules.

• Appropriates $225,000 to the Department of Health Care Policy and Financing and $81,675 to the Department of Human Services for fiscal year 2016-17 to implement the PACE ombudsman program and related actuarial services.