Medi-Cal: Program of All-Inclusive Care for the Elderly: rates.
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Majority
Fiscal committee
No
Appropriation
No
Current location
In Floor Process
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Overview
This bill modifies how the state pays PACE (Program of All-Inclusive Care for the Elderly) organizations under Medi-Cal. It simplifies the process by removing a requirement for PACE organizations to consult with the Department of Health Care Services before proposing rates. Instead, the department will negotiate rates with PACE organizations, providing 60 days’ notice and responding to feedback within 30 days before submitting rates for federal approval. The bill also requires the department to provide rationale for rate assumptions upon request.
Key provisions
- Removes the requirement for PACE organizations to consult with the Department of Health Care Services before proposing rates.
- Establishes a negotiation process between the Department of Health Care Services and PACE organizations for capitation rates.
- Requires the Department of Health Care Services to notify PACE organizations of proposed rates at least 60 days prior to submission to CMS.
- Mandates a 30-day response period for PACE organizations to provide feedback on proposed rates.
- Requires the Department of Health Care Services to provide rationale for rate assumptions upon request.
- Authorizes the Department of Health Care Services to define a reasonable date for PACE organizations to submit feedback.
- Specifies requirements for data sharing between the Department and PACE organizations.
- Addresses potential adjustments for new PACE organizations or areas.
Who is affected
Bill text
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