H.F. No. 4839 - PACE Program Summary

• Establishes the Program of All-Inclusive Care for the Elderly (PACE) in Minnesota as a community-based, capitated long-term care service for individuals aged 55 and older who are at risk of institutionalization.

• Eligible individuals must be screened by their county and found eligible for elderly waiver services or community access for disability inclusion, with a licensed physician certifying PACE is an appropriate alternative to institutionalized care.

• Commissioner of Human Services must submit a state plan amendment to federal Centers for Medicare and Medicaid Services by October 1, 2024, with PACE service operations established by June 30, 2025 for services beginning January 1, 2026.

• PACE organizations assume full financial risk under a capitated payment model, providing comprehensive acute and long-term care services through an interdisciplinary team approach, with capitation rates capped at 100 percent of Medicaid fee-for-service or managed care costs for actuarially similar populations.

• Participants may voluntarily enroll in PACE and receive all Medicare-covered items and services, all Medicaid-covered items and services, and any additional services determined necessary by the interdisciplinary team, with the option to disenroll at any time.