Section 1 Short title
This Act may be cited as the “Program of All-Inclusive Care for the Elderly Anytime Act” or the “PACE Anytime Act”.
Program of All-Inclusive Care for the Elderly Anytime Act
A BILL
To improve access to the Program of All-Inclusive Care for the Elderly, and for other purposes.
Sec. 2 Anytime enrollment in PACE
In general—
Anytime enrollment and effective date— Section 1894(c)(5) of the Social Security Act (42 U.S.C. 1395eee(c)(5)) is amended by adding at the end the following new subparagraph:
“(C) Anytime enrollment and effective date of enrollment
“(i) Anytime enrollment—A PACE program eligible individual may enroll in a PACE program at any time during a month.
“(ii) Effective date—Subject to clause (iii), the enrollment of a PACE program eligible individual in a PACE program shall be effective on the date the PACE provider operating the PACE program receives an enrollment agreement signed by such PACE program eligible individual with respect to such PACE program.
“(iii) Special rule in the case of dual eligible beneficiaries—In the case of a PACE program eligible individual who is eligible for benefits under this title and title XIX, clause (i) shall only apply if the State in which such individual resides has made an election under section 1934(c)(5)(C) to permit PACE program eligible individuals enroll in a PACE program at any time during a month in such State.”
Prorated payments— Section 1894(d) of the Social Security Act (42 U.S.C. 1395eee(d)) is amended by adding at the end the following new paragraph:
“(4) Prorated payments—In the case of a PACE program eligible individual enrolled in a PACE program operated by a PACE provider with an enrollment effective date that is not the first day of a month, the capitation amount that would otherwise be made under this subsection to the PACE provider for such individual for the first month in which such individual is so enrolled shall be prorated accordingly.”
Conforming amendments—
Anytime enrollment and effective date— Section 1934(c)(5) of the Social Security Act (42 U.S.C. 1396u–4(c)(5)) is amended by adding at the end the following new subparagraph:
“(C) State option to permit anytime enrollment and effective date of enrollment
“(i) Anytime enrollment—A State may elect to permit a PACE program eligible individual to enroll in a PACE program at any time during a month.
“(ii) Effective date—Pursuant to a State election made under clause (i), the enrollment of a PACE program eligible individual in a PACE program shall be effective on the date the PACE provider operating the PACE program receives an enrollment agreement signed by such PACE program eligible individual with respect to such PACE program.”
Prorated payments— Section 1934(d) of the Social Security Act (42 U.S.C. 1396u–4(d)) is amended by adding at the end the following new paragraph:
“(3) Prorated payments—If a State elects under subsection (c)(5)(C) to permit enrollment at any time during a month, in the case of a PACE program eligible individual enrolled in a PACE program operated by a PACE provider with an enrollment effective date that is not the first day of a month, the State shall prorate the capitation amount that would otherwise be made under this subsection to the PACE provider for such individual for the first month in which such individual is so enrolled.”
Effective date— The amendments made by this section shall take effect on January 1, 2025.