Bill > AB1672

This bill modifies how the State Department of Health Care Services (DHCS) negotiates and sets payment rates, known as capitation rates, for organizations participating in the Program of All-Inclusive Care for the Elderly (PACE) program, which provides community-based long-term care services for eligible seniors under Medi-Cal, California's Medicaid program. Currently, DHCS is required to consult with these PACE organizations when developing these rates. This bill removes that consultation requirement and instead mandates that capitation rates be negotiated directly between DHCS and each PACE organization. Before submitting proposed rates to the federal Centers for Medicare and Medicaid Services (CMS) for approval, DHCS must notify the PACE organization at least 60 days in advance and respond in writing to any comments or questions submitted by the PACE organization within 30 days of submission, with DHCS having the discretion to set a deadline for these submissions. Additionally, DHCS will provide the rationale for its rate assumptions and calculations upon request, and will make a good-faith effort to reach an agreement on the capitation rates with each PACE organization.

Budget and Finance, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260AB1672