CO SB209

Requires the state department to annually renegotiate monthly capitated rates for Program of All-Inclusive Care for the Elderly (PACE) services starting in fiscal year 2019-20 and thereafter.

Mandates the state department to develop an actuarially sound upper payment limit methodology in compliance with federal law, with participation from Colorado PACE organizations and a contracted actuary experienced in these methods.

Requires the state department and Colorado PACE programs to meet during the 2019 legislative interim no later than June 1, 2019 to consider appropriate funding methodology for fiscal years 2020-21 and beyond, plus other PACE-related issues including administration, regulation, oversight, and staffing needs.

Appropriates $6,755,479 from the general fund to the Department of Health Care Policy and Financing for the 2019-20 fiscal year for medical services premiums, with an anticipated matching amount of $6,755,479 in federal funds.

Maintains interim protections requiring the capitated rate percentage to be no less than the 2016-17 negotiated rate until the upper payment limit methodology is adopted in state board rules.