2005 Connecticut Code - Sec. 17b-28c. Application for a federal waiver for pilot program based on principles of national Program of All-Inclusive Care for the Elderly (PACE).
Sec. 17b-28c. Application for a federal waiver for pilot program based on
principles of national Program of All-Inclusive Care for the Elderly (PACE). The
Commissioner of Social Services may submit an application for a federal waiver for
the purpose of conducting a pilot program based on the principles of the national Program
of All-Inclusive Care for the Elderly (PACE): (1) To provide comprehensive health care
and care management services for elderly and disabled Medicaid recipients who may
also be eligible for Medicare; and (2) to simplify eligibility for Medicaid. The program
shall be designed to reduce costs and increase efficiency in the operation of the Medicaid
program and to improve the coordination of health care benefits with the Medicare
program. Under said program, the Commissioner of Social Services, in consultation
with the Insurance Commissioner, may initially enter into contracts with integrated
service networks which have successfully completed a feasibility study, in conjunction
with a PACE technical assistance center, for the provision of comprehensive long-term
health care and care management for participating Medicaid recipients on a prepayment
or per capita basis. The Commissioner of Social Services may make payments on such
basis to designated PACE sites from funds appropriated to the Medicaid account. The
Commissioner of Social Services, in such contracts, may establish conditions necessary
to operate such pilot program within available appropriations, including, but not limited
to, requiring a nursing facility to reduce its number of beds in a certificate of networks
shall emphasize the utilization of primary and community-based services to avoid utilization of institutional care. Eligible Medicaid recipients shall have a choice of enrolling
in an integrated service network or receiving Medicaid covered services in a fee-for-service program, and no copays or a lower level of optional Medicaid state plan services
than currently covered under fee-for-service Medicaid, shall be used to induce individuals to transfer into the networks.
History: June 18 Sp. Sess. P.A. 97-2 effective July 1, 1997; P.A. 98-198 amended Subsec. (a) to (1) allow the commissioner to submit an application for a federal waiver for purpose of conducting a pilot program based on the principles of the national Program of All-Inclusive Care for the Elderly (PACE), in lieu of requiring commissioner to submit an application for a federal waiver for an 1115 research and demonstration program; (2) authorize commissioner to "initially" enter into contracts with integrated service networks which have successfully completed a feasibility study, in conjunction with a PACE technical assistance center, for provision of health care for Medicaid recipients; (3) authorize commissioner to make payments to designated PACE sites from funds appropriated to Medicaid account; (4) allow commissioner to establish conditions in such contracts necessary to operate such pilot program within available appropriations; and (5) eliminate provisions which specify what the program may include; and eliminated Subsecs. (b) and (c) in their entirety, effective June 8, 1998.
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