249H.8 - PACE AND PRE-PACE PROGRAMS.
249H.8 PACE AND PRE-PACE PROGRAMS.
For the purposes of this chapter, all of the following apply to a
PACE program:
1. A person operating a PACE program shall have a PACE program
agreement with the centers for Medicare and Medicaid services of the
United States department of health and human services, shall enter
into a contract with the department of human services, and shall
comply with 42 U.S.C. § 1396(u)(4) and all regulations promulgated
pursuant to that section.
2. Services provided under a PACE or pre-PACE program shall be
provided on a capitated basis.
3. A pre-PACE program may contract with the department of human
services to provide services to individuals eligible for medical
assistance, on a capitated basis, for a limited scope of the PACE
service package through a prepaid health plan agreement, with the
remaining services reimbursed directly to the service providers by
the medical assistance or federal Medicare programs.
4. PACE and pre-PACE programs are not subject to regulation under
chapter 514B.
5. A PACE or pre-PACE program shall, at the time of entering into
the initial contract and of renewal of a contract with the department
of human services, demonstrate cash reserves in an amount established
by rule of the department to cover expenses in the event of
insolvency. Section History: Recent Form
2000 Acts, ch 1004, §8, 22; 2000 Acts, ch 1232, §62; 2002 Acts, ch
1050, §27