New JerseyNew Jersey would set minimum Medicaid payments to PACE programs
New Jersey would set minimum monthly Medicaid payments to PACE programs, with a lower minimum for participants also enrolled in Medicare.
What it does
PACE programs would receive at least 98% of the amount the state would pay for a Medicaid enrollee’s long-term care outside PACE.
For people enrolled in both Medicare and Medicaid, PACE programs would receive at least 95% of what the state would pay for their long-term care outside PACE.
A PACE program starting on or after July 1, 2026, would receive at least 98% of the comparison amount for all participants during its first 24 months.
Argument forPACE programs could receive steadier monthly payments, which may help them plan care for older adults and people with disabilities.
Argument againstThe state could pay more than it otherwise would for some participants because the minimum rates are tied to the cost of care outside PACE.
More detail
The state would set a monthly Medicaid payment rate for PACE programs at no less than 98% of a comparison amount. This applies to Medicaid enrollees receiving PACE services; people enrolled in both Medicare and Medicaid have a separate minimum rate. The comparison is what the state would pay for the person's long-term care through Medicaid fee-for-service outside PACE. The bill would take effect immediately if enacted.
The state would set a monthly Medicaid payment rate for these PACE participants at no less than 95% of a comparison amount. This applies to people receiving PACE services who are eligible for both Medicare and Medicaid. The comparison is what the state would pay for the person's long-term care through Medicaid fee-for-service outside PACE. The bill would take effect immediately if enacted.
The state would set a monthly Medicaid payment rate of at least 98% of the comparison amount for all participants in certain new PACE programs. This applies to all participants in a PACE program that begins operating on or after July 1, 2026. The comparison is what the state would pay for long-term care through Medicaid fee-for-service outside PACE. The 24-month period starts when the program begins operating.
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Where it stands
- Introduced
- Passed 1st Chamber
- Passed 2nd Chamber
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Sep 10Introduced, Referred to Assembly Aging and Human Services CommitteeIntroduced
Healthcare