PACE Part D Choice Act of 2023
If passed, HB3549 would significantly impact the current administrative framework governing the PACE (Programs of All-Inclusive Care for the Elderly) program. Specifically, it would enhance the autonomy of enrollees by allowing them to select a standalone prescription drug plan that may better meet their individual needs compared to the offerings from the PACE program itself. This change is seen as pivotal as it could potentially lower out-of-pocket costs for beneficiaries by increasing competition among drug plan providers and expanding available drug coverage alternatives. Additionally, the bill would require PACE programs to be proactive in educating enrollees about their new options and to facilitate their enrollment process.
House Bill 3549, also known as the PACE Part D Choice Act of 2023, aims to amend title XVIII of the Social Security Act specifically to ensure that Medicare-only PACE program enrollees have the option to choose their prescription drug plans under Medicare Part D. The bill proposes to add a new provision that allows participants in the PACE program to enroll in a qualified standalone prescription drug plan starting from the plan years that begin on or after January 1, 2025. The intention behind this legislation is to provide greater flexibility and choice to senior citizens and those enrolled in the PACE program, addressing the growing need for personalized healthcare options in an evolving medical landscape.
However, there are concerns associated with implementing HB3549. Critics worry that allowing PACE enrollees to opt for independent prescription plans may complicate care coordination efforts and lead to fragmented service delivery. Additionally, the legislation could impose new administrative burdens on PACE programs, which need to incorporate these changes while ensuring they continue to meet the comprehensive care requirements set forth by the original program structure. Opponents argue that the risk of increased costs and potential confusion for beneficiaries must be carefully weighed against the proposed benefits of enhanced choice.