Florida 2023 Regular Session

Florida House Bill H0693 Compare Versions

Only one version of the bill is available at this time.

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10	10	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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14	14	A bill to be entitled 1
15	15	An act relating to the administration of the Program 2
16	16	of All-Inclusive Care for the Elderly; amending s. 3
17	17	430.84, F.S.; deleting provisions requiring the Agency 4
18	18	for Health Care Administration to consult with the 5
19	19	Department of Elderly Affairs regarding administration 6
20	20	of the Program of All -Inclusive Care for the Elderly 7
21	21	(PACE) and prohibiting more than one PACE organization 8
22	22	within a specified service area; authorizi ng the 9
23	23	agency to enter into certain agreements with PACE 10
24	24	organizations and to adopt rules; providing an 11
25	25	effective date. 12
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27	27	Be It Enacted by the Legislature of the State of Florida: 14
28	28	15
29	29	Section 1. Section 430.84, Florida Statutes, is amended to 16
30	30	read: 17
31	31	430.84 Program of All -Inclusive Care for the Elderly. — 18
32	32	(1) DEFINITIONS.—As used in this section, the term: 19
33	33	(a) "Agency" means the Agency for Health Care 20
34	34	Administration. 21
35	35	(b) "Applicant" means an entity that has filed an 22
36	36	application with the agency for consideration as a Program of 23
37	37	All-Inclusive Care for the Elderly (PACE) organization. 24
38	38	(c) "CMS" means the Centers for Medicare and Medicaid 25
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47	47	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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51	51	Services within the United States Department of Health and Human 26
52	52	Services. 27
53	53	(d) "Department" means the Department of Elderly Affairs. 28
54	54	(d)(e) "PACE organization" means an entity under contract 29
55	55	with the agency to deliver PACE services. 30
56	56	(e)(f) "Participant" means an individual receiving 31
57	57	services from a PACE organization who has been determined by the 32
58	58	agency department to need the level of care required under the 33
59	59	state Medicaid plan for coverage of nursing facility services. 34
60	60	(2) PROGRAM CREATION. —The agency, in consultation with the 35
61	61	department, may approve entities that have submitted 36
62	62	applications required by the CM S to the agency for review and 37
63	63	consideration which contain the data and information required in 38
64	64	subsection (3) to provide benefits pursuant to the PACE program 39
65	65	as established in 42 U.S.C. s. 1395eee and in accordance with 40
66	66	the requirements set forth in this section. 41
67	67	(3) PACE ORGANIZATION SELECTION. —The agency, in 42
68	68	consultation with the department, shall, on a continuous basis, 43
69	69	review and consider applications required by the CMS for PACE 44
70	70	that have been submitted to the agency by entities seeking 45
71	71	initial state approval to become PACE organizations. Notice of 46
72	72	such applications shall be published in the Florida 47
73	73	Administrative Register. 48
74	74	(a) A prospective PACE organization shall submit 49
75	75	application documents to the agency before requesting program 50
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84	84	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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88	88	funding. Application documents submitted to and reviewed by the 51
89	89	agency, in consultation with the department, must include all of 52
90	90	the following: 53
91	91	1. Evidence that the applicant has the ability to meet all 54
92	92	of the applicable federal regulations and requirements, 55
93	93	established by the CMS, for participation as a PACE organization 56
94	94	by the proposed implementation date. 57
95	95	2. Market studies, including an estimate of the number of 58
96	96	potential participants and the geographic service area in which 59
97	97	the applicant proposes to serve. 60
98	98	3. A business plan of operation, including pro forma 61
99	99	financial statements and projections, based on the proposed 62
100	100	implementation date. 63
101	101	(b) Each applicant must propose to serve a unique and 64
102	102	defined geographic service area without duplication of services 65
103	103	or target populations. No more than one PACE organization may be 66
104	104	authorized to provide services within any unique and defined 67
105	105	geographic service area. 68
106	106	(b)(c) Upon agency approval, a PACE organization that is 69
107	107	authorized to provide and has received funding for P ACE slots in 70
108	108	a given geographic area may use such slots and funding to serve 71
109	109	the needs of participants in a contiguous geographic area if 72
110	110	such PACE organization is authorized to provide PACE services in 73
111	111	that area. 74
112	112	(c)(d) An existing PACE organization see king authority to 75
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121	121	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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125	125	serve an additional geographic service area not previously 76
126	126	authorized by the agency or Legislature shall meet the 77
127	127	requirements provided set forth in paragraphs (a) and (b). 78
128	128	(d)(e) Any prospective PACE organization that is granted 79
129	129	initial state approval by the agency , in consultation with the 80
130	130	department, shall submit its complete federal PACE application, 81
131	131	in accordance with the application process and guidelines 82
132	132	established by the CMS, to the agency and the CMS within 12 83
133	133	months after the date of initial state approval, or such 84
134	134	approval is void. 85
135	135	(4) ACCOUNTABILITY. —All PACE organizations must meet 86
136	136	specific quality and performance standards established by the 87
137	137	CMS and the state administering agency for the PACE program. 88
138	138	(a) The agency: 89
139	139	1. Shall oversee and monitor the PACE program and 90
140	140	organizations based upon data and reports periodically submitted 91
141	141	by PACE organizations to the agency and the CMS. 92
142	142	2. May execute two-way agreements or contracts with PACE 93
143	143	organizations to enhance oversigh t and monitoring of the PACE 94
144	144	program. 95
145	145	(b) A PACE organization is exempt from the requirements of 96
146	146	chapter 641. 97
147	147	(5) RULES.—The agency may adopt rules to administer this 98
148	148	section. 99
149	149	Section 2. This act shall take effect July 1, 2023. 100