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HB 750

Regards PACE program site expansion

136th Legislature (2025-2026) Introduced by Bill Roemer and 1 co-sponsor

Expands Ohio’s PACE by opening unserved counties to new providers through a structured RFP process, CMS-approved expansion, and uniform funding rates.

Reported - Amended
#aging #healthandhumanservices #medicaid
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Bill Summary · HB 750

Summary: HB 750 (135th/136th General Assembly) – PACE program site expansion (Ohio)

Purpose and intent

  • The bill aims to expand Ohio’s Program of All-Inclusive Care for the Elderly (PACE) by expanding eligibility to currently unserved counties. It requires the Ohio Department of Aging (ODA) to solicit proposals from entities interested in becoming PACE organizations in those unserved counties and to establish a process for approval and CMS enrollment, with uniform pricing for new PACE providers.

Key provisions and changes

  • Expansion timeline and process
    • The ODA must issue a request for proposals (RFP) by December 31, 2026, from entities seeking to become PACE organizations in counties not currently served by PACE.
    • Proposals must be submitted to the ODA within 90 days after the RFP is issued.
    • The ODA may issue additional requests for proposals or expand outside the RFP process, and rates for new PACE organizations must be the same as rates for existing PACE entities as of the effective date.
  • Eligibility criteria for proposing entities
    • Provide a feasibility study of the proposed service area.
    • Hold a current, valid Medicaid provider agreement or be eligible to enter into one by the time services begin.
    • Meet all federal requirements applicable to PACE organizations.
    • Demonstrate experience delivering health care services to frail older adults; ensure all staff (employees and contractors) comply with federal PACE personnel qualifications.
    • Have a facility suitable to be a PACE center or have a plan to acquire/build/expand a suitable facility before beginning services in the proposed area.
    • Meet any additional requirements established by rules adopted by the ODA.
  • Review and approval
    • The ODA will review all proposals and determine which entities are qualified to become PACE organizations for each service area.
    • The qualification determinations must be completed by June 30, 2027.
  • CMS participation
    • An ODA-qualified entity may apply to CMS to become a PACE organization.
    • ODA must provide support to such entities in complying with federal requirements to pursue CMS approval.
  • Implementation after CMS approval
    • Each CMS-approved entity must begin providing services to participants no later than two years after CMS approval notice, consistent with federal funding rules.
  • Rulemaking authority
    • The Director of Aging may adopt rules to implement the expansion, following the Administrative Procedure Act.

Affected parties

  • State agencies
    • Ohio Department of Aging (ODA): responsible for issuing the RFP, reviewing proposals, determining qualified entities, and supporting CMS applications; may promulgate necessary rules.
    • Ohio Department of Medicaid (ODM) and CMS relationship: cost and rates under PACE will affect Medicaid spending decisions; entities enrolling in PACE interact with Medicaid financing.
  • Entities seeking to become PACE providers
    • Hospitals, integrated health networks, or other organizations eligible to operate PACE, meeting the specified criteria.
  • PACE participants
    • Ohio residents in currently unserved counties who would gain access to PACE services (comprehensive medical and social services provided through PACE to frail older adults).

Financial and operational implications

  • Rates
    • New PACE organizations must be paid at the same rate as existing PACE programs, ensuring price parity for new entrants.
  • Costs to state agencies
    • ODA: administrative costs related to processing applications, supporting new providers, and rulemaking.
    • ODM: potential shifts in costs depending on whether enrollees originate from other Medicaid coverage streams (e.g., managed care or home-and-community-based waivers). Costs could rise or fall depending on enrollment mix and service utilization.
  • Overall impact
    • The fiscal note indicates variability based on enrollment and provider recruitment outcomes; potential for either increased or decreased Medicaid expenditures depending on how PACE enrollment compares to current Medicaid care expenditures.

Timeline at a glance

  • December 31, 2026: ODA must issue the RFP for unserved counties.
  • Within 90 days of RFP issuance: Entities submit proposals to ODA.
  • By June 30, 2027: ODA must determine which entities are qualified to become PACE organizations for each service area.
  • Post-qualification: Qualified entities may apply to CMS for approval; once CMS approves, entities must begin providing PACE services within two years.

Procedural notes

  • The Director of Aging can adopt implementing rules under the Administrative Procedure Act.
  • The bill preserves flexibility to issue additional solicitations or expand beyond the initial RFP process.

Context

  • Ohio currently has PACE sites in several counties with ongoing expansions planned (as noted in the fiscal note). This bill formalizes a structured pathway to extend PACE to unserved counties and standardizes entry rates across new providers.

Compiled from official sources — confirm details with the bill’s official record.

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