NY S06664

Establishes a state-level Program of All-Inclusive Care for the Elderly (PACE) under Public Health Law Article 29-EE, providing community-based, risk-based, and capitated long-term care services to eligible Medicaid and Medicare beneficiaries effective January 1, 2023.

Requires PACE organizations to operate a diagnostic and treatment center (PACE center) and implement an interdisciplinary team approach to care management, while establishing a unified licensure process incorporating requirements from multiple articles of Public Health Law.

Sets eligibility requirements for individuals age 55 or older who meet nursing home level of care criteria, reside within an approved service area, and can be safely maintained in the community, with voluntary enrollment and conformance to federal eligibility standards when broader than state requirements.

Mandates the Department of Health develop a payment methodology ensuring PACE rates do not exceed what would otherwise be paid for comparable services under the state plan, while requiring transparency in providing actuarial documentation to PACE organizations.

Repeals one provision of Social Services Law section 364-j and amends another to require independent actuaries provide complete actuarial memorandums and assumptions to managed care providers thirty days before rate submission to federal Medicare and Medicaid Centers.