PACE Program Funding Methodology

Medicaid - PACE program funding - interim review of funding methodology - appropriation. The act directs the department of health care policy and financing (department) to negotiate the monthly contracted rate for PACE program services for the 2019-20 fiscal year, and each fiscal year thereafter, using an actuarially sound upper payment limit methodology that complies with federal law regarding PACE organizations.

The act repeals provisions in statute directing the department to apply a grade of membership method in determining the upper payment limit methodology and tying the 2019-20 fiscal year appropriations to a new methodology or to the fiscal year 2016-17 appropriation.

The act requires the department and PACE organizations to meet during the 2019 legislative interim to consider the appropriate funding methodology for PACE programs and other issues relating to PACE delivery models, administrative oversight and funding administrative services, and appropriations requests.

For the 2019-20 state fiscal year, the act appropriates $6,755,479 to the department of health care policy and financing for medical assistance premiums for the PACE program, with the expectation of receiving the same amount in matching federal funds.

(Note: This summary applies to this bill as enacted.)