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Draft PACE Regulations Presented to Public Health and Health Planning Council

(July 9, 2024) A unified licensure process for Programs of All-Inclusive Care for the Elderly (PACE programs) would be implemented under draft regulations presented to the Public Health and Health Planning Council (PHHPC) on June 20th. The draft regulations, which have not yet been published in the State Register, would implement legislation enacted in 2022. Current regulations require PACE programs to adhere to the State licensure and operating standards and procedures for managed long term care (MLTC) plans, diagnostic and treatment centers (DTCs), and home care agencies, as well as federal requirements. The new regulations, if adopted, would create a consolidated State licensure process that incorporates the criteria of the existing licenses and applies PHHPC approval requirements to the PACE program in its entirety, rather than its DTC and home care agency components.

The new regulations include:

  • the elements of the application process;
  • requirements for approval of a PACE license, including character and competence of proposed operators;
  • requirements for revision, amendment, or modification of a PACE application;
  • requirements to withdraw or abandon a PACE license application;
  • grounds for revocation, limitation, or annulment of a PACE license;
  • responsibilities of the PACE governing body, prohibition on delegation of certain responsibilities to a management entity, and prohibition on the sharing of revenue with an entity that has not received establishment approval;
  • prohibition on agents, nominees, and fiduciaries as operators of PACE programs;
  • procedures for name or purpose changes of operators of medical facilities related to PACE programs.

Existing PACE programs may be authorized to continue operating, subject to the discretion of the Department of Health (DOH) and based on criteria to be developed by the Commissioner. The preamble to the draft regulations suggests that existing programs will be required to transition into full compliance with the new regulations, but the timing and process for doing so is not clear. The draft regulations would require existing programs to notify DOH of their intent to continue operating within 30 days of the effective date of the new regulations. Any material change in an existing PACE program, such as a change in services, location, or operators, would trigger requirements to be licensed under the new regulations.

Pending PACE applications and all new applications would be reviewed under the new regulations once adopted. The new regulations would take effect 180 days after adoption.

The draft regulations are expected to be published in the State Register for public comment in the near future. The version presented to the PHHPC is available here (pp. 55-92). LeadingAge NY will be reviewing the published proposed regulations and submitting comments. Members are encouraged to share any comments on the regulations with LeadingAge NY for inclusion in the association’s comments.

Contact: Karen Lipson, klipson@leadingageny.org