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.
   17  Be It Enacted by the Legislature of the State of Florida:
   19         Section 1. Section 430.84, Florida Statutes, is amended to
   20  read:
   21         430.84 Program 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.