The bill amends section 173.503 of the Revised Code to introduce a presumptive eligibility component for the Program of All-Inclusive Care for the Elderly (PACE). This allows applicants to receive services temporarily while their full eligibility is determined. The bill also specifies that a PACE organization can enroll an individual on the first day of the month following their application, even before their Medicaid application is approved, provided they meet other eligibility requirements. If the individual is found to be Medicaid eligible, the Department of Medicaid will reimburse the PACE organization for services provided from the enrollment date. If the individual is ineligible for Medicaid, the PACE organization will assume financial responsibility for the duration of the individual's enrollment.

Additionally, the bill repeals section 173.502 and the existing section 173.503, and establishes a process for expanding the PACE program. The Department of Aging is required to issue a request for proposals from entities interested in becoming PACE organizations in underserved counties by December 31, 2026. Entities must meet specific requirements, including providing a feasibility study and demonstrating experience in healthcare for frail older adults. The Department will review proposals and determine qualified entities by June 30, 2027, with approved entities required to begin providing services within two years of CMS approval.

Statutes affected:
As Reported By House Committee: 173.503, 173.502