Page:United States Statutes at Large Volume 111 Part 1.djvu/563

From Wikisource
Jump to navigation Jump to search
This page needs to be proofread.

PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 539 (3) by inserting after section 1933, as added by such section, the following new section: "P ROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) 42 USC 1396U-4. "SEC. 1934. (a) STATE OPTION. — "(1) IN GENERAL.—^A State may elect to provide medical assistance under this section with respect to PACE program services to PACE program eligible individuals who are eligible for medical assistance under the State plan and who are enrolled in a PACE program under a PACE program agreement. Such individuals need not be eligible for benefits under part A, or enrolled under part B, of title XVIII to be eligible to enroll under this section. In the case of an individual enrolled with a PACE program pursuant to such an election— "(A) the individual shall receive benefits under the plan solely through such program, and "(B) the PACE provider shall receive payment in accordance with the PACE program agreement for provision of such benefits. A State may establish a numerical limit on the number of individuals who may be enrolled in a PACE program under a PACE program agreement. "(2) PACE PROGRAM DEFINED. — For purposes of this section, the term 'PACE program' means a program of all-inclusive care for the elderly that meets the following requirements: "(A) OPERATION. —The entity operating the program is a PACE provider (as defined in paragraph (3)). " (B) COMPREHENSIVE BENEFiTS.The program provides comprehensive health care services to PACE program eligible individuals in accordance with the PACE program agreement and regulations under this section. "(C) TRANSITION.—In the case of an individual who is enrolled under the program under this section and whose enrollment ceases for any reason (including that the individual no longer qualifies as a PACE program eligible individual, the termination of a PACE program agreement, or otherwise), the program provides assistance to the individual in obtaining necessary transitional care through appropriate referrals and making the individual's medical records available to new providers. "(3) PACE PROVIDER DEFINED. — "(A) IN GENERAL.—For purposes of this section, the term 'PACE provider' means an entity that— "(i) subject to subparagraph (B), is (or is a distinct part of) a public entity or a private, nonprofit entity organized for charitable purposes under section 501(c)(3) of the Internal Revenue Code of 1986, and "(ii) has entered into a PACE program agreement with respect to its operation of a PACE program. " (B) TREATMENT OF PRIVATE, FOR-PROFIT PROVIDERS. — Clause (i) of subparagraph (A) shall not apply— "(i) to entities subject to a demonstration project waiver under subsection (h); and "(ii) after the date the report under section 4804(b) of the Balanced Budget Act of 1997 is submitted, unless the Secretary determines that any of the findings