Sec. 2. PACE expansion grant program
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In this section: The term area agency on aging has the meaning given that term in section 102 of the Older Americans Act of 1965 ( 42 U.S.C. 3002 ). The term CMS means the Centers for Medicare & Medicaid Services. The term for-profit PACE provider means a PACE provider that is operated by an entity that is not a public entity or a private, nonprofit entity organized for charitable purposes under section 501(c)(3) of the Internal Revenue Code of 1986. The term PACE pilot site means a PACE provider that— has been approved to provide services in a geographic service area that is, in whole or in part, a rural area or an underserved urban area; and has received a grant under subsection (b).
The term PACE program has the meaning given that term in sections 1894(a)(2) and 1934(a)(2) of the Social Security Act ( 42 U.S.C. 1395eee(a)(2) ; 1396u–4(a)(2)). The term PACE provider has the meaning given that term in section 1894(a)(3) or 1934(a)(3) of the Social Security Act ( 42 U.S.C. 1395eee(a)(3) ; 1396u–4(a)(3)). The term rural area has the meaning given that term in section 1886(d)(2)(D) of the Social Security Act ( 42 U.S.C. 1395ww(d)(2)(D) ). The term Secretary means the Secretary of Health and Human Services.
The term underserved urban area means an urban health professional shortage area (as such term is defined in section 332 of the Public Health Service Act ( 42 U.S.C. 254e )). The Secretary shall establish a process and criteria to award grants to qualified PACE providers that have been approved to serve a rural area or an underserved urban area. To be eligible for a grant under subparagraph (A), a PACE provider shall demonstrate to the Secretary that the provider has a plan to partner with— each area agency on aging serving the area that the provider is approved to serve; or if there is no area agency on aging serving such area, the applicable State Unit on Aging.
A grant awarded under subparagraph
(A)to any individual PACE pilot site shall not exceed $1,000,000. Not more than 30 PACE pilot sites shall be awarded a grant under subparagraph (A). Funds made available under a grant awarded under subparagraph
(A)may be used for the following expenses only to the extent such expenses are incurred in relation to establishing or delivering PACE program services in a rural area or underserved urban area: Feasibility analysis and planning. Interdisciplinary team development. Development of a provider network, including contract development. Development or adaptation of claims processing systems. Preparation of special education and outreach efforts required for the PACE program. Development of any special quality of care or patient satisfaction data collection efforts. Purchase or lease of a building. Modifications to a building. To cover the cost of reinsurance during the grant period. Establishment of a working capital fund to sustain fixed administrative, facility, or other fixed costs until the provider reaches sufficient enrollment size. Startup and development costs incurred prior to the approval of the PACE pilot site’s PACE provider application, new center application, or service area expansion application by CMS. Any other efforts determined by the PACE pilot site to be critical to its successful startup, as approved by the Secretary. A PACE provider shall only be eligible to receive a grant under this subsection if the provider is not a for-profit PACE provider. A PACE provider shall not be eligible for a grant under this subsection unless the provider has entered into an agreement, consistent with sections 1894 and 1934 of the Social Security Act ( 42 U.S.C. 1395eee , 1396u–4), and regulations promulgated to carry out such sections, among the PACE provider, the Secretary, and a State administering agency for the operation of a PACE program by the provider under such sections. The Secretary shall establish a technical assistance program to provide— outreach and education to State agencies and provider organizations interested in establishing and expanding PACE programs in rural areas or underserved urban areas; and technical assistance necessary to support PACE pilot sites. There is appropriated to the Secretary $30,000,000 to carry out this subsection, to remain available until expended. Not later than 60 months after the date of enactment of this Act, the Secretary shall submit a report to Congress, including the Special Committee on Aging of the Senate and the Committee on Finance of the Senate, containing an evaluation of the experience of PACE pilot sites in rural areas and underserved urban areas. The Secretary shall establish a process and criteria to award State expansion grants to qualified State agencies in States that do not currently have PACE providers. A State expansion grant awarded under subparagraph
(A)to any State agency shall not exceed $100,000. Funds made available under a State expansion grant awarded under paragraph
(1)may be used for the following expenses only to the extent such expenses are incurred in relation to establishing a PACE program in the State: Expenditures related to the development of a capitated payment rate model, including appropriate risk adjustment, for making payments to PACE providers under a PACE program agreement. Expenditures on any other efforts determined by the State Medicaid agency to be critical to the successful implementation of a PACE program in the State, as approved by the Secretary. There are appropriated to the Secretary $2,000,000 to carry out this subsection, to remain available until expended. Social Security Act Any amounts paid under the authority of this section to a PACE provider shall be in addition to payments made to the provider under section 1894 or 1934 of the Social Security Act ( 42 U.S.C. 1395eee ; 1396u–4).
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