Bill would set minimum Medicaid payments for elder care programs

New Jersey would set a minimum monthly Medicaid payment to PACE programs. This general rule covers PACE members enrolled in Medicaid. Another provision sets a 95% minimum for members who also have Medicare. The minimum is 98% of what the state would pay if the person received long-term care outside PACE through Medicaid's pay-per-service system. This rule would take effect immediately if the bill became law.

New Jersey would set a 95% minimum monthly Medicaid payment for PACE members who have both Medicare and Medicaid. This provision covers PACE members enrolled in both Medicare and Medicaid. The bill also states a 98% minimum for Medicaid members generally. The comparison is what the state would pay if the person received long-term care outside PACE through Medicaid's pay-per-service system. This rule would take effect immediately if the bill became law.

New Jersey would set a 98% monthly Medicaid payment minimum for newly operating PACE programs. This rule covers all participants in a PACE program that begins operating on or after July 1, 2026. The minimum is based on what the state would pay if each participant received long-term care outside PACE through Medicaid's pay-per-service system. The 24 months start when the program begins operating. The bill itself would take effect immediately if it became law.