HB 750

As Reported by the House Health Committee
136th General Assembly
   Regular Session  Am. H. B. No. 750
       2025-2026
  Representatives Roemer, White, A.
  Cosponsor: Representative Schmidt
  To amend section 173.503 and to repeal section  1
  173.502 of the Revised Code regarding site  2
  expansion and timely enrollment for the Program  3
  of All-Inclusive Care for the Elderly (PACE).  4
 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
     Section 1. That section 173.503 of the Revised Code be  5
amended to read as follows:  6
     Sec. 173.503. The department of aging shall seek to  7
implement a presumptive eligibility component to the PACE  8
program, under which applicants for PACE may receive services  9
under the program during a temporary period, to begin  10
immediately upon application and a finding of presumptive  11
eligibility, while a PACE organization conducts a full  12
eligibility determination on behalf of the individual. If the  13
individual is determined to be ineligible for PACE, the PACE  14
organization that found the individual presumptively eligible  15
shall be responsible for the costs of PACE services provided to  16
the individual during the presumptive eligibility period.A PACE  17
organization may enroll an individual in PACE on the first day  18
of the month following the date the individual applied for PACE  19
and begin providing PACE services to the individual before the  20
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individual's medicaid application has been approved, if the  21
department of aging has determined that the individual meets all  22
other PACE eligibility requirements. If the individual is found  23
to be medicaid eligible, the department of medicaid shall  24
reimburse the PACE organization for PACE services provided to  25
the individual by the organization, beginning on the date the  26
individual was enrolled in PACE under this section. If the  27
individual is determined to be ineligible for medicaid, the PACE  28
organization shall assume financial responsibility for the  29
length of the individual's enrollment in PACE. The PACE  30
organization may request the individual pay the private pay rate  31
for PACE services. If the participant chooses not to pay the  32
private pay rate, the PACE organization may follow the  33
department of aging's involuntary disenrollment requirements to  34
disenroll the individual.  35
       Section 2. That existing section 173.503 of the Revised  36
Code is hereby repealed.  37
       Section 3. That section 173.502 of the Revised Code is  38
hereby repealed.  39
       Section 4. (A) As used in this section:  40
       (1) "CMS" means the United States Centers for Medicare and  41
Medicaid Services.  42
       (2) "Entity" has the same meaning as in 42 C.F.R. 460.10.  43
       (3) "PACE center," "PACE organization," "participant," and  44
"state administering agency" have the same meanings as in 42  45
C.F.R. 460.6.  46
       (B)(1) Not later December 31, 2026, the Department of  47
Aging shall issue a request for proposals from any entity  48
interested in becoming a PACE organization located in a county  49
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of this state not served by the PACE program on the effective  50
date of this section. Proposals shall be submitted to the  51
Department not later than ninety days after the date the  52
Department issues the request for proposals.  53
       (2) Division (B)(1) of this section does not prevent the  54
Department from expanding the PACE program outside of the  55
process required by that division, including by issuing other  56
requests for proposals. All rates for new PACE organizations  57
added on or after the effective date of this section by a  58
request for proposal shall be the same as for PACE organizations  59
in existence on that date.  60
       (C) To be eligible for approval by the Department to  61
become a PACE organization, an entity that submits a proposal  62
pursuant to division (B)(1) of this section shall meet all of  63
the following requirements:  64
       (1) The entity provides a feasibility study of its  65
proposed service area to the Department.  66
       (2) The entity has a current, valid provider agreement, as  67
defined in section 5164.01 of the Revised Code, or will be  68
eligible to enter into a provider agreement by the time that the  69
entity will begin providing services under the PACE program.  70
       (3) The entity meets all federal requirements applicable  71
to PACE organizations.  72
       (4) The entity demonstrates to the satisfaction of the  73
Department that the organization has experience providing health  74
care services to frail older adults and that each member of the  75
entity's staff, including employees and contractors, complies  76
with 42 C.F.R. 460.64.  77
       (5) The entity has a facility suitable to be a PACE  78
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center, or plans to acquire, build, or expand a facility  79
suitable to be a PACE center prior to beginning services, in its  80
proposed service area, as described in the request for proposals  81
process.  82
       (6) The entity meets any additional requirements in rules  83
adopted by the Department pursuant to division (G) of this  84
section.  85
       (D) The Department shall review all proposals submitted in  86
accordance with division (B)(1) of this section. The Department  87
shall determine from the proposals which entities it considers  88
qualified to become PACE organizations for each service area.  89
The determination shall be made not later than June 30, 2027.  90
       (E) An entity considered by the Department as qualified to  91
become a PACE organization may apply to CMS to become a PACE  92
organization. The Department shall provide support to any such  93
organization that applies to CMS by complying with federal  94
requirements.  95
       (F) Each entity approved to become a PACE organization by  96
CMS shall begin providing services to participants not later  97
than two years after the entity receives notice of its approval  98
from CMS, consistent with federal financial participation.  99
       (G) The Director of Aging may adopt rules to implement  100
this section. The rules shall be adopted in accordance with  101
Chapter 119. of the Revised Code.  102