Bill > S477

This bill establishes the Program of All-Inclusive Care for the Elderly (PACE), a comprehensive healthcare service model designed to help elderly Massachusetts residents who meet specific eligibility criteria remain in their community while receiving integrated medical and long-term care services. The program will be administered by MassHealth and allows dually eligible individuals (those qualifying for both Medicare and Medicaid) to voluntarily enroll in a care program managed by an Interdisciplinary Care Team (IDT). Participants must meet nursing facility level of care criteria but be able to safely live in a community setting. The bill outlines detailed requirements for PACE organizations, including providing comprehensive healthcare services through day health centers, homes, and other settings, and ensuring voluntary enrollment with the right to disenroll. The legislation mandates that MassHealth educate consumers about the program, provide comprehensive educational materials, and use a capitation payment model where PACE organizations receive a set monthly payment per enrollee. The bill also establishes income-related eligibility guidelines, privacy protections under HIPAA, and provides a process for appealing eligibility decisions. Importantly, the program aims to offer an alternative to nursing home placement by providing holistic, integrated care that supports seniors' independence and quality of life.

Health and Social Services

https://malegislature.gov/Bills/194/S477