Florida Senate - 2023 SB 1504 By Senator Hutson 7-01800A-23 20231504__ 1 A bill to be entitled 2 An act relating to the administration of the Program 3 of All-Inclusive Care for the Elderly; amending s. 4 430.84, F.S.; deleting the definition of the term 5 department; revising the definition of the term 6 participant; deleting provisions requiring the 7 Agency for Health Care Administration to consult with 8 the Department of Elderly Affairs regarding 9 administration of the Program of All-Inclusive Care 10 for the Elderly (PACE); revising application 11 requirements for a prospective PACE organization to 12 request program funding; requiring the agency to 13 execute certain agreements or contracts with PACE 14 organizations; authorizing the agency to adopt rules; 15 providing an effective date. 16 17 Be It Enacted by the Legislature of the State of Florida: 18 19 Section 1.Section 430.84, Florida Statutes, is amended to 20 read: 21 430.84Program of All-Inclusive Care for the Elderly. 22 (1)DEFINITIONS.As used in this section, the term: 23 (a)Agency means the Agency for Health Care 24 Administration. 25 (b)Applicant means an entity that has filed an 26 application with the agency for consideration as a Program of 27 All-Inclusive Care for the Elderly (PACE) organization. 28 (c)CMS means the Centers for Medicare and Medicaid 29 Services within the United States Department of Health and Human 30 Services. 31 (d)Department means the Department of Elderly Affairs. 32 (e)PACE organization means an entity under contract with 33 the agency to deliver PACE services. 34 (e)(f)Participant means an individual receiving services 35 from a PACE organization who has been determined by the agency 36 department to need the level of care required under the state 37 Medicaid plan for coverage of nursing facility services. 38 (2)PROGRAM CREATION.The agency, in consultation with the 39 department, may approve entities that have submitted 40 applications required by the CMS to the agency for review and 41 consideration which contain the data and information required in 42 subsection (3) to provide benefits pursuant to the PACE program 43 as established in 42 U.S.C. s. 1395eee and in accordance with 44 the requirements set forth in this section. 45 (3)PACE ORGANIZATION SELECTION.The agency, in 46 consultation with the department, shall, on a continuous basis, 47 review and consider applications required by the CMS for PACE 48 that have been submitted to the agency by entities seeking 49 initial state approval to become PACE organizations. Notice of 50 such applications must shall be published in the Florida 51 Administrative Register. 52 (a)A prospective PACE organization must shall submit 53 application documents to the agency before requesting program 54 funding. Application documents submitted to and reviewed by the 55 agency, in consultation with the department, must include all of 56 the following: 57 1.Evidence that the applicant has the ability to meet all 58 of the applicable federal regulations and requirements, 59 established by the CMS, for participation as a PACE organization 60 by the proposed implementation date. 61 2.Market studies, including an estimate of the number of 62 potential participants and the geographic service area in which 63 the applicant proposes to serve. 64 3.A business plan of operation, including pro forma 65 financial statements and projections, based on the proposed 66 implementation date. 67 (b)Each applicant must propose to serve a unique and 68 defined geographic service area without duplication of services 69 or target populations. No more than one PACE organization may be 70 authorized to provide services within any unique and defined 71 geographic service area. 72 (c)Upon agency approval, a PACE organization that is 73 authorized to provide and has received funding for PACE slots in 74 a given geographic area may use such slots and funding to serve 75 the needs of participants in a contiguous geographic area if 76 such PACE organization is authorized to provide PACE services in 77 that area. 78 (c)(d)An existing PACE organization seeking authority to 79 serve an additional geographic service area not previously 80 authorized by the agency or Legislature shall meet the 81 requirements of paragraph (a) set forth in paragraphs (a) and 82 (b). 83 (d)(e)Any prospective PACE organization that is granted 84 initial state approval by the agency, in consultation with the 85 department, shall submit its complete federal PACE application, 86 in accordance with the application process and guidelines 87 established by the CMS, to the agency and the CMS within 12 88 months after the date of initial state approval, or such 89 approval is void. 90 (4)ACCOUNTABILITY.All PACE organizations must meet 91 specific quality and performance standards established by the 92 CMS and the state administering agency for the PACE program. 93 (a)The agency shall do all of the following: 94 1.Oversee and monitor the PACE program and organizations 95 based upon data and reports periodically submitted by PACE 96 organizations to the agency and the CMS. 97 2.Execute two-way agreements or contracts with PACE 98 organizations to enhance oversight and monitoring of the PACE 99 program. 100 (b)A PACE organization is exempt from the requirements of 101 chapter 641. 102 (5)RULES.The agency may adopt rules to administer this 103 section. 104 Section 2.This act shall take effect July 1, 2023.