S4781-118

1. Short title This Act may be cited as the Program of All-Inclusive Care for the Elderly Anytime Act or the PACE Anytime Act.

2. Anytime enrollment in PACE Section 1894(c)(5) of the Social Security Act (42 U.S.C. 1395eee(c)(5)) is amended by adding at the end the following new subparagraph: A PACE program eligible individual may enroll in a PACE program at any time during a month. Subject to clause (iii), the enrollment of a PACE program eligible individual in a PACE program shall be effective on the date the PACE provider operating the PACE program receives an enrollment agreement signed by such PACE program eligible individual with respect to such PACE program. In the case of a PACE program eligible individual who is eligible for benefits under this title and title XIX, clause (i) shall only apply if the State in which such individual resides has made an election under section 1934(c)(5)(C) to permit PACE program eligible individuals enroll in a PACE program at any time during a month in such State. Section 1894(d) of the Social Security Act (42 U.S.C. 1395eee(d)) is amended by adding at the end the following new paragraph: In the case of a PACE program eligible individual enrolled in a PACE program operated by a PACE provider with an enrollment effective date that is not the first day of a month, the capitation amount that would otherwise be made under this subsection to the PACE provider for such individual for the first month in which such individual is so enrolled shall be prorated accordingly. Section 1934(c)(5) of the Social Security Act (42 U.S.C. 1396u–4(c)(5)) is amended by adding at the end the following new subparagraph: A State may elect to permit a PACE program eligible individual to enroll in a PACE program at any time during a month. Pursuant to a State election made under clause (i), the enrollment of a PACE program eligible individual in a PACE program shall be effective on the date the PACE provider operating the PACE program receives an enrollment agreement signed by such PACE program eligible individual with respect to such PACE program. Section 1934(d) of the Social Security Act (42 U.S.C. 1396u–4(d)) is amended by adding at the end the following new paragraph: If a State elects under subsection (c)(5)(C) to permit enrollment at any time during a month, in the case of a PACE program eligible individual enrolled in a PACE program operated by a PACE provider with an enrollment effective date that is not the first day of a month, the State shall prorate the capitation amount that would otherwise be made under this subsection to the PACE provider for such individual for the first month in which such individual is so enrolled. The amendments made by this section shall take effect on January 1, 2025. (C)Anytime enrollment and effective date of enrollment(i)Anytime enrollmentA PACE program eligible individual may enroll in a PACE program at any time during a month.(ii)Effective dateSubject to clause (iii), the enrollment of a PACE program eligible individual in a PACE program shall be effective on the date the PACE provider operating the PACE program receives an enrollment agreement signed by such PACE program eligible individual with respect to such PACE program.(iii)Special rule in the case of dual eligible beneficiariesIn the case of a PACE program eligible individual who is eligible for benefits under this title and title XIX, clause (i) shall only apply if the State in which such individual resides has made an election under section 1934(c)(5)(C) to permit PACE program eligible individuals enroll in a PACE program at any time during a month in such State.. (4)Prorated paymentsIn the case of a PACE program eligible individual enrolled in a PACE program operated by a PACE provider with an enrollment effective date that is not the first day of a month, the capitation amount that would otherwise be made under this subsection to the PACE provider for such individual for the first month in which such individual is so enrolled shall be prorated accordingly.. (C)State option to permit anytime enrollment and effective date of enrollment(i)Anytime enrollmentA State may elect to permit a PACE program eligible individual to enroll in a PACE program at any time during a month.(ii)Effective datePursuant to a State election made under clause (i), the enrollment of a PACE program eligible individual in a PACE program shall be effective on the date the PACE provider operating the PACE program receives an enrollment agreement signed by such PACE program eligible individual with respect to such PACE program.. (3)Prorated paymentsIf a State elects under subsection (c)(5)(C) to permit enrollment at any time during a month, in the case of a PACE program eligible individual enrolled in a PACE program operated by a PACE provider with an enrollment effective date that is not the first day of a month, the State shall prorate the capitation amount that would otherwise be made under this subsection to the PACE provider for such individual for the first month in which such individual is so enrolled..