Amendment #451 to H3400

PACE Medicaid Capitation Payments

Representatives McMurtry of Dedham, DiNatale of Fitchburg, O'Day of West Boylston, Heroux of Attleboro, Miceli of Wilmington, Rogers of Norwood and Malia of Boston move to amend the bill by adding the following new section:

Section XX.  The Secretary of the executive office of health and human services is directed to develop a methodology for establishing capitation rates to be paid by Medicaid to PACE programs. The methodology shall be based on an actuarially sound determination of reasonable costs incurred for the services provided by PACE but in no case shall the rate determined be in excess of the Upper Payment Level.  The rate shall be reviewed on an annual basis. The methodology used shall be made available to PACE providers.