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Texas Human Resources Code - Section 32.053. PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE). (a) The department, as a part of the medical assistance program, shall develop and implement a program of all-inclusive care for the elderly (PACE) in accordance with Section 4802 of the Balanced Budget Act of 1997 (Pub. L. No. 105-33), as amended. The department shall provide medical assistance to a participant in the PACE program in the manner and to the extent authorized by federal law. (b) The department shall adopt rules as necessary to implement this section. In adopting rules, the department shall: (1) use the Bienvivir Senior Health Services of El Paso initiative as a model for the program; and (2) ensure that a person is not required to hold a certificate of authority as a health maintenance organization under the Texas Health Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance Code) to provide services under the PACE program. (c) The department may not contract with a person to provide services under the PACE program unless the person: (1) purchases reinsurance in an amount determined by the department that is sufficient to ensure the person's continued solvency; or (2) has the financial resources sufficient to cover expenses in the event of the person's insolvency. (d) To demonstrate sufficiency of financial resources for purposes of Subsection (c)(2), a person may use cash reserves, a letter of credit, a guarantee of a company affiliated with the person, or a combination of those arrangements. The amount of a person's financial arrangement must be at least equal to the sum of: (1) the total capitation revenue for one month; and (2) the average monthly payment of operating expenses. (e) The department, with the cooperation of the Texas Department on Aging and area agencies on aging, shall develop and implement a coordinated plan to promote PACE program sites operating under this section. The department shall adopt policies and procedures to ensure that caseworkers and any other appropriate department staff discuss the benefits of participating in the PACE program with long-term care clients. Added by Acts 2001, 77th Leg., ch. 170, § 1, eff. Sept. 1, 2001

Legal Research Home > Texas Laws > Human Resources Code > Texas Human Resources Code - Section 32.053. PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE). (a) The department, as a part of the medical assistance program, shall develop and implement a program of all-inclusive care for the elderly (PACE) in accordance with Section 4802 of the Balanced Budget Act of 1997 (Pub. L. No. 105-33), as amended. The department shall provide medical assistance to a participant in the PACE program in the manner and to the extent authorized by federal law. (b) The department shall adopt rules as necessary to implement this section. In adopting rules, the department shall: (1) use the Bienvivir Senior Health Services of El Paso initiative as a model for the program; and (2) ensure that a person is not required to hold a certificate of authority as a health maintenance organization under the Texas Health Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance Code) to provide services under the PACE program. (c) The department may not contract with a person to provide services under the PACE program unless the person: (1) purchases reinsurance in an amount determined by the department that is sufficient to ensure the person's continued solvency; or (2) has the financial resources sufficient to cover expenses in the event of the person's insolvency. (d) To demonstrate sufficiency of financial resources for purposes of Subsection (c)(2), a person may use cash reserves, a letter of credit, a guarantee of a company affiliated with the person, or a combination of those arrangements. The amount of a person's financial arrangement must be at least equal to the sum of: (1) the total capitation revenue for one month; and (2) the average monthly payment of operating expenses. (e) The department, with the cooperation of the Texas Department on Aging and area agencies on aging, shall develop and implement a coordinated plan to promote PACE program sites operating under this section. The department shall adopt policies and procedures to ensure that caseworkers and any other appropriate department staff discuss the benefits of participating in the PACE program with long-term care clients. Added by Acts 2001, 77th Leg., ch. 170, § 1, eff. Sept. 1, 2001

§ 32.053.  PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY 
(PACE).  (a)  The department, as a part of the medical assistance 
program, shall develop and implement a program of all-inclusive 
care for the elderly (PACE) in accordance with Section 4802 of the 
Balanced Budget Act of 1997 (Pub. L. No. 105-33), as amended.  The 
department shall provide medical assistance to a participant in the 
PACE program in the manner and to the extent authorized by federal 
law.
	(b)  The department shall adopt rules as necessary to 
implement this section.  In adopting rules, the department shall:
		(1)  use the Bienvivir Senior Health Services of El 
Paso initiative as a model for the program;  and
		(2)  ensure that a person is not required to hold a 
certificate of authority as a health maintenance organization under 
the Texas Health Maintenance Organization Act (Chapter 20A, 
Vernon's Texas Insurance Code) to provide services under the PACE 
program.
	(c)  The department may not contract with a person to provide 
services under the PACE program unless the person:
		(1)  purchases reinsurance in an amount determined by 
the department that is sufficient to ensure the person's continued 
solvency;  or
		(2)  has the financial resources sufficient to cover 
expenses in the event of the person's insolvency.
	(d)  To demonstrate sufficiency of financial resources for 
purposes of Subsection (c)(2), a person may use cash reserves, a 
letter of credit, a guarantee of a company affiliated with the 
person, or a combination of those arrangements.  The amount of a 
person's financial arrangement must be at least equal to the sum of:
		(1)  the total capitation revenue for one month;  and                         
		(2)  the average monthly payment of operating expenses.                       
	(e)  The department, with the cooperation of the Texas 
Department on Aging and area agencies on aging, shall develop and 
implement a coordinated plan to promote PACE program sites 
operating under this section.  The department shall adopt policies 
and procedures to ensure that caseworkers and any other appropriate 
department staff discuss the benefits of participating in the PACE 
program with long-term care clients.

Added by Acts 2001, 77th Leg., ch. 170, § 1, eff. Sept. 1, 2001.           

Last modified: August 11, 2007