H.R. 10547
PACE Access Improvement Act
Sponsor: Debbie Dingell
1 cosponsor
Official summary
No official summary yet.
Text of the bill
(a) In general
(1) Any time enrollment and effective date. Section 1894(c)(5) of the Social Security Act (42 U.S.C. 1395eee(c)(5)) is amended by adding at the end the following new subparagraph:
(C) Any time enrollment and effective date of enrollment
(i) Any time enrollment. With respect to enrollments made on or after January 1, 2027, a PACE program eligible individual may enroll in a PACE program at any time during a month.
(ii) Effective date. With respect to enrollments made on or after January 1, 2027, the enrollment of a PACE program eligible individual in a PACE program shall be effective on the date the PACE provider operating the PACE program receives an enrollment agreement signed by such PACE program eligible individual with respect to such PACE program.
(2) Prorated payments. Section 1894(d) of the Social Security Act (42 U.S.C. 1395eee(d)) is amended by adding at the end the following new paragraph:
(4) Prorated payments. With respect to enrollments made on or after January 1, 2027, in the case of a PACE program eligible individual enrolled in a PACE program operated by a PACE provider with an enrollment effective date that is not the first day of a month, the capitation amount that would otherwise be made under this subsection to the PACE provider for such individual for the first month in which such individual is so enrolled shall be prorated accordingly.
(b) Requirements under medicaid
(1) Any time enrollment and effective date. Section 1934(c)(5) of the Social Security Act (42 U.S.C. 1396u–4(c)(5)) is amended by adding at the end the following new subparagraph:
(C) Any time enrollment and effective date of enrollment
(i) Any time enrollment. With respect to enrollments made on or after January 1, 2027, a PACE program eligible individual may enroll in a PACE program in a State at any time during a month.
(ii) Effective date. With respect to enrollments made on or after January 1, 2027, the enrollment of a PACE program eligible individual in a PACE program shall be effective on the date the PACE provider operating the PACE program receives an enrollment agreement signed by such PACE program eligible individual with respect to such PACE program.
(2) Prorated payments. Section 1934(d) of the Social Security Act (42 U.S.C. 1396u–4(d)) is amended by adding at the end the following new paragraph:
(3) Prorated payments. With respect to enrollments made on or after January 1, 2027, in the case of a PACE program eligible individual enrolled in a PACE program operated by a PACE provider with an enrollment effective date that is not the first day of a month, the State shall prorate the capitation amount that would otherwise be made under this subsection to the PACE provider for such individual for the first month in which such individual is so enrolled.