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Application for a federal waiver for pilot program based on principles of national Program of All-Inclusive Care for the Elderly (PACE) - Conn. Gen. Stat. § 17b-28c

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The Commissioner of Social Services may apply for a Medicaid waiver in order to establish a “pilot program based on the principles of the national Program of All-Inclusive Care for the Elderly (PACE).” The pilot program will provide elderly and disabled Medicaid beneficiaries, including those eligible for Medicare, with “comprehensive health care and care management services.” The Commissioner must design the program to reduce Medicaid costs, increase Medicaid efficiency, and improve the Medicare and Medicaid benefit coordination. The Commissioner may implement the program by contracting with “integrated service networks” that have demonstrated their ability to provide “comprehensive long-term health care and care management” services to Medicaid recipients “on a prepayment or per capita basis.” Participating integrated services networks must “emphasize the utilization of primary and community-based services to avoid utilization of institutional care.”

Medicaid beneficiaries must have a choice of whether to participate in the program. The Commissioner may not incentivize participation in the program by eliminating copays or reducing the number of optional Medicaid state plan services.

Current as of June 2015