HB3628 Summary

• Renames the "All-Inclusive Care for the Elderly Act" to the "Program of All-Inclusive Care for the Elderly Act" and establishes PACE (Program of All-Inclusive Care for the Elderly) as a covered benefit under Illinois Medicaid.

• Requires the Department of Healthcare and Family Services to submit a State Plan amendment to CMS by March 1, 2022, establishing PACE as an optional service providing community-based, risk-based, and capitated long-term care services.

• Mandates specific implementation timelines including issuance of requests for proposals by August 1, 2022, and beginning to accept and approve PACE applications by October 1 and November 1, 2023, respectively.

• Establishes capitation rate requirements at no less than 95% of fee-for-service equivalent costs and creates detailed rate-setting methodology using actuarial methods that account for high-cost drugs and regional variations.

• Protects core PACE model requirements that cannot be waived, including focus on frail elderly, comprehensive integrated care, interdisciplinary teams, capitated financing, and full financial risk assumption by contracted organizations.