Bill > S2825

This bill establishes the Program of All-Inclusive Care for the Elderly (PACE) within MassHealth, creating a comprehensive healthcare service model for seniors who meet specific eligibility criteria. The program allows eligible seniors who require nursing facility-level care to receive integrated medical and social services while remaining in their community, with services provided through interdisciplinary care teams at day health centers, homes, and other healthcare settings. Key provisions include voluntary enrollment, the ability to disenroll at any time, and coverage of Medicare Part A and B services, Medicaid-covered services, and mental health and substance abuse treatments. MassHealth will contract with PACE organizations to provide these services, ensure consumer education about the program, and develop educational materials explaining PACE's function, eligibility standards, and consumer rights. The bill specifies that PACE will use dual capitation payment agreements with Medicare and Medicaid, meaning PACE organizations will receive a set monthly payment per enrollee to cover all necessary services. Enrollees must be Massachusetts residents who meet specific clinical criteria, including being able to live safely in a community setting, and the program will protect participants' privacy in accordance with HIPAA regulations. The legislation aims to provide comprehensive, coordinated care that helps seniors maintain independence and receive necessary medical and social support.

Health and Social Services

Joint Committee on Aging and Independence (Other)

https://malegislature.gov/Bills/194/S2825