Florida Senate - 2020 SENATOR AMENDMENT
Bill No. HB 833
Ì249638QÎ249638
LEGISLATIVE ACTION
Senate . House
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Floor: 1/AD/2R .
03/12/2020 04:40 PM .
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Senator Baxley moved the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Section 430.84, Florida Statutes, is created to
6 read:
7 430.84 Program of All-Inclusive Care for the Elderly.—
8 (1) DEFINITIONS.—As used in this section, the term:
9 (a) “Agency” means the Agency for Health Care
10 Administration.
11 (b) “Applicant” means an entity that has filed an
12 application with the agency for consideration as a Program of
13 All-Inclusive Care for the Elderly (PACE) organization.
14 (c) “CMS” means the Centers for Medicare and Medicaid
15 Services within the United States Department of Health and Human
16 Services.
17 (d) “Department” means the Department of Elderly Affairs.
18 (e) “PACE organization” means an entity under contract with
19 the agency to deliver PACE services.
20 (f) “Participant” means an individual receiving services
21 from a PACE organization and who has been determined by the
22 department to need the level of care required under the state
23 Medicaid plan for coverage of nursing facility services.
24 (2) PROGRAM CREATION.—The agency, in consultation with the
25 department, may approve entities that have submitted
26 applications required by the CMS to the agency for review and
27 consideration which contain the data and information required in
28 subsection (3) to provide benefits pursuant to the PACE program
29 as established in 42 U.S.C. s. 1395eee and in accordance with
30 the requirements set forth in this section.
31 (3) PACE ORGANIZATION SELECTION.—The agency, in
32 consultation with the department, shall on a continuous basis
33 review and consider applications required by the CMS for PACE
34 which have been submitted to the agency by entities seeking
35 initial state approval to become PACE organizations. Notice of
36 such applications must be published in the Florida
37 Administrative Register.
38 (a) A prospective PACE organization shall submit
39 application documents to the agency before requesting program
40 funding. Application documents submitted to and reviewed by the
41 agency, in consultation with the department, must include all of
42 the following:
43 1. Evidence that the applicant is able to meet all of the
44 applicable federal regulations and requirements established by
45 the CMS for participation as a PACE organization by the proposed
46 implementation date.
47 2. Market studies, including an estimate of the number of
48 potential participants and the geographic service area in which
49 the applicant proposes to serve.
50 3. A business plan of operation, including pro forma
51 financial statements and projections, based on the proposed
52 implementation date.
53 (b) Each applicant must propose to serve a unique and
54 defined geographic service area without duplication of services
55 or target populations. No more than one PACE organization may be
56 authorized to provide services within any unique and defined
57 geographic service area. The proposed geographic service area
58 must not overlap with or include any part of a geographic
59 service area that was previously authorized by the Legislature
60 and that is specific to another prospective PACE organization.
61 (c) An existing PACE organization seeking authority to
62 serve an additional geographic service area not previously
63 authorized by the agency or the Legislature must meet the
64 requirements set forth in paragraphs (a) and (b).
65 (d) Any prospective PACE organization that is granted
66 initial state approval by the agency, in consultation with the
67 department, shall submit its complete federal PACE application,
68 in accordance with the application process and guidelines
69 established by the CMS, to the agency and the CMS within 12
70 months after the date of initial state approval, or such
71 approval is void.
72 (4) ACCOUNTABILITY.—All PACE organizations must meet
73 specific quality and performance standards established by the
74 CMS and the state administering agency for the PACE program. The
75 agency shall oversee and monitor the PACE program and
76 organizations based upon data and reports periodically submitted
77 by PACE organizations to the agency and the CMS. A PACE
78 organization is exempt from the requirements of chapter 641.
79 (5) TRANSFER OF APPROVAL AND ASSIGNMENT OF PACE CONTRACT.
80 Any person whom the agency has approved to enroll participants
81 residing in a specific geographic area in a Program of All
82 Inclusive Care for the Elderly may transfer such approval, and
83 assign its PACE contract, to any other person meeting federal
84 requirements upon the prior approval of the agency and subject
85 to any other required federal approval. Such approved transfer
86 must include the transfer of any funds the Legislature
87 appropriated to such Program of All-Inclusive Care for the
88 Elderly, and all future appropriations with respect to such
89 Program of All-Inclusive Care for the Elderly must be made to
90 the approved transferee.
91 (6) CONSTRUCTION.—This section is subject to, and does not
92 repeal or alter, any law in effect on June 30, 2020, which
93 authorized a geographic service area and initial enrollees for a
94 prospective PACE organization.
95 Section 2. This act shall take effect July 1, 2020.
96
97 ================= T I T L E A M E N D M E N T ================
98 And the title is amended as follows:
99 Delete everything before the enacting clause
100 and insert:
101 A bill to be entitled
102 An act relating to the Program of All-Inclusive Care
103 for the Elderly; creating s. 430.84, F.S.; defining
104 terms; authorizing the Agency for Health Care
105 Administration, in consultation with the Department of
106 Elderly Affairs, to approve certain applicants to
107 provide benefits pursuant to the Program of All
108 Inclusive Care for the Elderly (PACE); specifying
109 requirements and procedures for the submission,
110 publication, review, and initial approval of
111 applications; requiring prospective PACE organizations
112 that are granted initial approval to apply within a
113 certain timeframe for federal approval; providing
114 accountability requirements; exempting PACE
115 organizations from certain requirements; authorizing
116 the transfer of PACE approvals and the assignment of
117 PACE contracts if certain conditions are met;
118 specifying a requirement for future appropriations to
119 approved transferees; providing construction;
120 providing an effective date.