H.R. 10547: PACE Access Improvement Act

This bill would change rules for the Program of All-Inclusive Care for the Elderly, or PACE, which provides medical and long-term care services for certain older adults who are eligible for nursing-home-level care but live in the community.

What the bill would do

• Allow people to enroll in PACE at any time during the month starting January 1, 2027, instead of being limited to certain enrollment timing rules.
• Make enrollment effective as soon as the PACE provider receives a signed enrollment agreement for enrollments on or after January 1, 2027.
• Require prorated payments for the first month if a person’s enrollment starts on a day other than the first of the month.
• Make it easier for PACE providers to apply to expand by allowing applications for new provider status, service area expansions, and new PACE center sites to be submitted at any time, and in some cases multiple times in the same quarter.
• Create a “deemed approved” process for certain applications if the federal government does not act within 45 days, unless it denies the request or asks for more information.
• Allow some staffing and contracting requirements to be satisfied by written assurances rather than requiring all personnel contracts to be fully in place at the application stage.
• Let qualified PACE providers add a new center site in an existing service area without filing a full application if they submit a qualifying notice and meet certain conditions.
• Require states, after a transition period, to offer PACE services to eligible people enrolled in PACE programs, instead of making it optional for states.
• Set deadlines for state compliance with that requirement: 180 days after enactment for states that already have at least one PACE agreement, and 3 years after enactment for states that do not.
• Remove certain marketing restrictions so that PACE programs and applicants can begin marketing once they have submitted a complete application, using marketing practices allowed under prior federal rules.
• Remove an older numerical limit related to PACE program participation and replace it with a broader requirement for the federal government and states to establish procedures for entering into, extending, and ending PACE agreements for providers that meet the program rules.

Timing and implementation

• Some changes would take effect immediately upon enactment.
• Several enrollment, payment, application, and marketing changes would apply starting January 1, 2027, or 180 days after enactment.
• States may get extra time if the federal government determines that state legislation is needed to comply.

Relevant Companies

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