HB 693 2023
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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
A bill to be entitled 1
An act relating to the administration of the Program 2
of All-Inclusive Care for the Elderly; amending s. 3
430.84, F.S.; deleting provisions requiring the Agency 4
for Health Care Administration to consult with the 5
Department of Elderly Affairs regarding administration 6
of the Program of All -Inclusive Care for the Elderly 7
(PACE) and prohibiting more than one PACE organization 8
within a specified service area; authorizi ng the 9
agency to enter into certain agreements with PACE 10
organizations and to adopt rules; providing an 11
effective date. 12
13
Be It Enacted by the Legislature of the State of Florida: 14
15
Section 1. Section 430.84, Florida Statutes, is amended to 16
read: 17
430.84 Program of All -Inclusive Care for the Elderly. — 18
(1) DEFINITIONS.—As used in this section, the term: 19
(a) "Agency" means the Agency for Health Care 20
Administration. 21
(b) "Applicant" means an entity that has filed an 22
application with the agency for consideration as a Program of 23
All-Inclusive Care for the Elderly (PACE) organization. 24
(c) "CMS" means the Centers for Medicare and Medicaid 25
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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
Services within the United States Department of Health and Human 26
Services. 27
(d) "Department" means the Department of Elderly Affairs. 28
(d)(e) "PACE organization" means an entity under contract 29
with the agency to deliver PACE services. 30
(e)(f) "Participant" means an individual receiving 31
services from a PACE organization who has been determined by the 32
agency department to need the level of care required under the 33
state Medicaid plan for coverage of nursing facility services. 34
(2) PROGRAM CREATION. —The agency, in consultation with the 35
department, may approve entities that have submitted 36
applications required by the CM S to the agency for review and 37
consideration which contain the data and information required in 38
subsection (3) to provide benefits pursuant to the PACE program 39
as established in 42 U.S.C. s. 1395eee and in accordance with 40
the requirements set forth in this section. 41
(3) PACE ORGANIZATION SELECTION. —The agency, in 42
consultation with the department, shall, on a continuous basis, 43
review and consider applications required by the CMS for PACE 44
that have been submitted to the agency by entities seeking 45
initial state approval to become PACE organizations. Notice of 46
such applications shall be published in the Florida 47
Administrative Register. 48
(a) A prospective PACE organization shall submit 49
application documents to the agency before requesting program 50
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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
funding. Application documents submitted to and reviewed by the 51
agency, in consultation with the department, must include all of 52
the following: 53
1. Evidence that the applicant has the ability to meet all 54
of the applicable federal regulations and requirements, 55
established by the CMS, for participation as a PACE organization 56
by the proposed implementation date. 57
2. Market studies, including an estimate of the number of 58
potential participants and the geographic service area in which 59
the applicant proposes to serve. 60
3. A business plan of operation, including pro forma 61
financial statements and projections, based on the proposed 62
implementation date. 63
(b) Each applicant must propose to serve a unique and 64
defined geographic service area without duplication of services 65
or target populations. No more than one PACE organization may be 66
authorized to provide services within any unique and defined 67
geographic service area. 68
(b)(c) Upon agency approval, a PACE organization that is 69
authorized to provide and has received funding for P ACE slots in 70
a given geographic area may use such slots and funding to serve 71
the needs of participants in a contiguous geographic area if 72
such PACE organization is authorized to provide PACE services in 73
that area. 74
(c)(d) An existing PACE organization see king authority to 75
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serve an additional geographic service area not previously 76
authorized by the agency or Legislature shall meet the 77
requirements provided set forth in paragraphs (a) and (b). 78
(d)(e) Any prospective PACE organization that is granted 79
initial state approval by the agency , in consultation with the 80
department, shall submit its complete federal PACE application, 81
in accordance with the application process and guidelines 82
established by the CMS, to the agency and the CMS within 12 83
months after the date of initial state approval, or such 84
approval is void. 85
(4) ACCOUNTABILITY. —All PACE organizations must meet 86
specific quality and performance standards established by the 87
CMS and the state administering agency for the PACE program. 88
(a) The agency: 89
1. Shall oversee and monitor the PACE program and 90
organizations based upon data and reports periodically submitted 91
by PACE organizations to the agency and the CMS. 92
2. May execute two-way agreements or contracts with PACE 93
organizations to enhance oversigh t and monitoring of the PACE 94
program. 95
(b) A PACE organization is exempt from the requirements of 96
chapter 641. 97
(5) RULES.—The agency may adopt rules to administer this 98
section. 99
Section 2. This act shall take effect July 1, 2023. 100