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Code · BILL · 113th Congress · S. 1228 (Introduced in Senate) — To establish a program to provide incentive payments to participating Medicare beneficiaries who voluntarily establis... · Sec. 5

Sec. 5. Participation of programs of all-inclusive care for the elderly (PACE)

590 words·~3 min read·/bill/113/s/1228/is/section-5

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Section 1894 of the Social Security Act (42 U.S.C. 1395eee) is amended by inserting at the end the following: Effective for PACE program agreements entered into on or after the date of enactment of the Medicare Better Health Rewards Program Act of 2013 , a PACE provider may provide to PACE program eligible individuals enrolled under this section with the PACE provider incentive payments, including cash, cash-equivalent, or other types of incentives, for voluntary participation in a Better Health Rewards Program (in this subsection referred to as the Program ) that rewards enrollees for meeting certain health targets established by the Secretary.
In no case shall the payment to a PACE provider under this section (or any premium charged by the provider under this section) with respect to PACE program eligible individuals enrolled with the PACE provider take into account any incentive payments made to individuals under the Program. The Program under this subsection shall be conducted in a similar manner to the manner in which the program under section 1849 is conducted, in accordance with standards established by the Secretary.
A PACE provider seeking to participate in the Program shall— notify the Secretary of the PACE provider's intent to participate in the Program; and agree to provide to the Secretary— information regarding— which PACE program eligible individuals enrolled with the PACE provider participate in the Program; the scores of those individuals with respect to applicable health targets under the Program; and the incentives individuals receive for meeting such health targets; and any other information specified by the Secretary for purposes of this subsection.
The Secretary may waive such requirements of titles XI, XVIII, and XIX as may be necessary to carry out the purposes of the Program established under this subsection. . Section 1934 of the Social Security Act ( 42 U.S.C. 1396u–4 ) is amended by adding at the end the following new subsection: Effective for PACE program agreements entered into on or after the date of enactment of the Medicare Better Health Rewards Program Act of 2013 , a PACE provider may provide to PACE program eligible individuals enrolled under this section with the PACE provider incentive payments, including cash, cash-equivalent, or other types of incentives, for voluntary participation in a Better Health Rewards Program (in this subsection referred to as the Program ) that rewards enrollees for meeting certain health targets established by the Secretary.
In no case shall the payment to a PACE provider under this section (or any premium charged by the provider under this section) with respect to PACE program eligible individuals enrolled with the PACE provider take into account any incentive payments made to individuals under the Program. The Program under this subsection shall be conducted in a similar manner to the manner in which the program under section 1849 is conducted, in accordance with standards established by the Secretary.
A PACE provider seeking to participate in the Program shall— notify the Secretary of the PACE provider's intent to participate in the Program; and agree to provide to the Secretary— information regarding— which PACE program eligible individuals enrolled with the PACE provider participate in the Program; the scores of those individuals with respect to applicable health targets under the Program; and the incentives individuals receive for meeting such health targets; and any other information specified by the Secretary for purposes of this subsection.
The Secretary may waive such requirements of titles XI, XVIII, and XIX as may be necessary to carry out the purposes of the Program established under this subsection. .
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  • 42 USC 1396u–4
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Sec. 5
Participation of programs of all-inclusive care for the elderly (PACE)
Cite42 USC 1396u–4
Cites 2Cited by 0 across 0 sources
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