PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Congressional Research Service
No official summary is available in the imported record yet.
People & committees
Rep. Dingell, Debbie [D-MI-6] · D–MI
Legislative record
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Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Sep 29, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2026-09-24 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The proposed PACE Access Improvement Act would let eligible people join a PACE care program during any part of a month, with enrollment starting when the provider receives their signed agreement. It would require states to cover program services for eligible Medicaid participants who enroll, subject to implementation deadlines. It would also change how providers obtain permission to open or expand programs.
This Act may be cited as the PACE Access Improvement Act.
the enrollment of a PACE program eligible individual in a PACE program shall be effective on the date the PACE provider operating the PACE program receives an enrollment agreement signed by such PACE program eligible individual with respect to such PACE program.
a PACE program eligible individual may enroll in a PACE program at any time during a month.
the State, beginning on the compliance date described in section 1934(a)(11) with respect to such State, shall provide medical assistance with respect to PACE program services to PACE program eligible individuals who are eligible for medical assistance under the State plan or under a waiver of such plan and who are enrolled in a PACE program under a PACE program agreement.
Revised processes for new provider status, service area expansions, and additions of PACE center sites
For enrollments on or after January 1, 2027, the bill would allow eligible people to enroll at any time during a month under both sets of PACE enrollment provisions. Enrollment would take effect when the provider receives the person's signed enrollment agreement.
With respect to enrollments made on or after January 1, 2027, a PACE program eligible individual may enroll in a PACE program at any time during a month.
With respect to enrollments made on or after January 1, 2027, a PACE program eligible individual may enroll in a PACE program in a State at any time during a month.
With respect to enrollments made on or after January 1, 2027, the enrollment of a PACE program eligible individual in a PACE program shall be effective on the date the PACE provider operating the PACE program receives an enrollment agreement signed by such PACE program eligible individual with respect to such PACE program.
For those enrollments, a provider's first-month capitation payment—a payment for an enrolled person—would be reduced proportionally when enrollment starts after the first day of the month. The Medicaid provision would expressly require the state to make that adjustment.
With respect to enrollments made on or after January 1, 2027, in the case of a PACE program eligible individual enrolled in a PACE program operated by a PACE provider with an enrollment effective date that is not the first day of a month, the capitation amount that would otherwise be made under this subsection to the PACE provider for such individual for the first month in which such individual is so enrolled shall be prorated accordingly.
the State shall prorate the capitation amount that would otherwise be made under this subsection to the PACE provider for such individual for the first month in which such individual is so enrolled.
Beginning January 1, 2027, entities seeking approval as new PACE providers could apply at any time and submit multiple applications in the same quarter.
Beginning January 1, 2027, the following shall apply: (i) Seeking new PACE provider status An entity may submit an application for the purpose described in section 460.10(a)(1) of title 42, Code of Federal Regulations, or any successor regulation, at any time and may submit multiple applications for such purpose in the same quarter.
Beginning January 1, 2027, applications to expand a service area, add a center, or do both could also be submitted at any time and more than once per quarter. These applications would remain subject to the referenced first trial-period audit requirements.
Beginning January 1, 2027, the following shall apply:
Seeking service area expansion or addition of PACE center site (but not both) (I) In general An entity may submit an application for a purpose described in section 460.10(a)(2) of title 42, Code of Federal Regulations, or any successor regulation, at any time, subject to the requirements of section 460.12(d) of such title (relating to the first trial period audit), or any successor regulation, and may submit multiple applications for such purpose in the same quarter.
Seeking both service area expansion and addition of PACE center site An entity may submit an application for the purposes described in section 460.10(a)(3) of title 42, Code of Federal Regulations, or any successor regulation, at any time, subject to the requirements of section 460.12(d) of such title (relating to the first trial period audit), or any successor regulation, and may submit multiple applications for such purposes in the same quarter.
Under the new process, a qualified provider adding a center within its existing service area, without expanding that area, could submit a qualifying notice instead of an application to the Secretary. The Secretary could set the notice's timing by regulation, and the notice would not count as an application under the referenced application regulations.
A qualified PACE provider (as defined in subparagraph (E)(ii)) operating a PACE program in a service area that seeks to add a PACE center site under such PACE program to such service area (and does not also seek to expand its service area) shall not be required to submit an application to the Secretary in order to so add such PACE center site if the qualified PACE provider submits to the Secretary (at such time as the Secretary may specify in regulation) a qualifying notice (as defined in subparagraph (E)(i)) with respect to the proposed additional PACE center site.
Such a qualifying notice shall not be considered an application for purposes of subpart B of part 460 of title 42, Code of Federal Regulations, or any successor to such regulations.
To qualify for the notice route, a provider would have to have successfully completed the program's first trial-period audit. At the time of the notice, that program could not be subject to a sanction, enforcement action, or termination proceeding under the specified regulations.
a PACE provider that, at the time of submission of a qualifying notice to the Secretary— (I) has successfully completed the first trial period audit with respect to such PACE program; and (II) is not the subject of a sanction, an enforcement action or a termination proceeding under subpart D of part 460 of title 42, Code of Federal Regulations, or any successor regulation, with respect to such PACE program.
The notice would need assurances that the new center is within the existing service area, that the state administering agency is willing to amend the program agreement to include it, and that the bill's staffing and contracting assurances are met.
(I) An assurance that the additional PACE center site will be located within such service area of such PACE program. (II) An assurance from the State administering agency of the State in which the PACE program is located that the State is willing to amend the PACE program agreement to include the additional PACE center site in such service area. (III) Each of the assurances described in subparagraph (C)(ii).
Applications for new provider status, service-area expansion, or additional centers would be automatically treated as approved unless the Secretary denied them in writing or requested additional information in writing within 45 days of submission. After receiving that information, the Secretary would have another 45 days to deny the application before automatic approval.
An application described in subparagraph (A)(i), (A)(ii)(I), or (A)(iii) shall be deemed approved unless the Secretary, within 45 days after the date of the submission of the application to the Secretary, either denies such request in writing or informs the applicant in writing with respect to any additional information that is needed in order to make a final determination with respect to the application. After the date the Secretary receives such additional information, the application shall be deemed approved unless the Secretary, within 45 days of such date, denies such request.
Applicants could replace specified hiring and contract-execution deadlines with assurances that the required care team would be employed or under contract, and all contractor agreements executed, by the time the proposed center becomes operational.
such assurances shall be treated as satisfying any application or other requirement applying a deadline by which the members of the interdisciplinary team described in section 460.102(b) of title 42, Code of Federal Regulations, or any successor regulation, are required to be employees or contractors of the proposed PACE center site and any deadline by which the PACE provider’s contracts for contracted health care providers, personnel, staff, or other contractors to provide contracted services must be executed
(I) An assurance that the required members of the interdisciplinary team are employees or contractors of the proposed PACE center site or will be employees or contractors of the proposed PACE center site by the time the PACE center becomes operational. (II) An assurance that the PACE provider’s contracts for all contractors and contracted personnel will be executed by the time the proposed PACE center site becomes operational.
For new-provider, expansion, and added-center arrangements, providers could write contracts that make staffing levels track enrollment up to the program's full projected number of participants.
In executing contracts with contracted health care providers, personnel, staff, or other contractors to provide contracted services or to establish an interdisciplinary team, for a purpose described in clause (i), (ii)(I), (ii)(II), or (iii) of subparagraph (A), a PACE provider may include provisions for staffing levels to be commensurate with enrollment to full projected census.
The bill would change state provision of PACE services from optional to required on each state's compliance date. Required Medicaid coverage would apply to people who meet PACE eligibility rules, qualify for Medicaid under the state plan or a waiver, and enroll under a PACE program agreement.
by striking A State may elect to provide and inserting Before the compliance date described in paragraph (11) with respect to a State, the State may elect to provide, and on and after such compliance date with respect to the State, the State shall provide
shall provide medical assistance with respect to PACE program services to PACE program eligible individuals who are eligible for medical assistance under the State plan or under a waiver of such plan and who are enrolled in a PACE program under a PACE program agreement.
The bill would delete the sentence allowing states to set a numerical limit on enrollment under a PACE program agreement.
by striking A State may establish a numerical limit on the number of individuals who may be enrolled in a PACE program under a PACE program agreement.
Subject to the section's implementation exception, a state with at least one PACE provider agreement at enactment would have to comply after 180 days. A state without such an agreement would have three years after enactment.
subject to section 4(c) of the PACE Access Improvement Act, the compliance date with respect to a State is— (A) in the case of a State that, as of the date of the enactment of this paragraph, has in effect a PACE program agreement with at least 1 PACE provider to operate a PACE program in the State, the date that is 180 days after such date of enactment; and (B) in the case of a State that is not described in subparagraph (A), the date that is 3 years after such date of enactment.
Unless otherwise specified, section 4's amendments would take effect at enactment and apply to medical assistance provided starting 180 days later, subject to the state-legislation exception.
Except as provided in paragraph (2) and unless otherwise specified, the amendments made by this section shall take effect on the date of the enactment of this Act and shall apply beginning with respect to medical assistance provided on the date that is 180 days after such date of enactment.
If the Secretary of Health and Human Services determined that a state needed legislation other than an appropriation to comply, its Medicaid plan would receive temporary protection from a noncompliance finding based solely on these new requirements. That protection would run until the first calendar quarter beginning after the first regular legislative session ending after enactment. Each year of a two-year session would count separately.
which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of the failure of the plan to meet such additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that ends after the date of the enactment of this section.
in the case of a State that has a 2-year legislative session, each year of the session is deemed to be a separate regular session of the State legislature.
PACE programs, including entities applying to become programs, could begin marketing to prospective eligible participants when they submit a complete application. This would cover applications for initial approval, service-area expansion, a new center, or both expansion and a new center; the text gives conditionally approved marketing materials as an example.
A specified PACE program (as defined in subclause (II)) that submits a complete application to the Secretary (as determined under section 460.20 of title 42, Code of Federal Regulations, or any successor regulation) for any of the purposes described in subclause (III) may conduct marketing activities with respect to prospective PACE program eligible individuals, such as making available marketing materials that have been conditionally approved by the Secretary, on or after the date the specified PACE program submits such complete application.
the term specified PACE program means a PACE program, and includes an entity that submits an application to CMS for approval as a PACE program.
(aa) For an entity seeking approval from the Secretary as a PACE program. (bb) For a PACE program seeking to expand its service area. (cc) For a PACE program seeking to add a new PACE center. (dd) For a PACE program seeking to expand its service area and to add a new PACE center.
The bill would permit marketing practices described in 42 C.F.R. 460.82(e)(5) as it existed on June 1, 2025, and repeal that regulatory provision. The supplied text does not describe those practices, so it does not establish which specific marketing methods would become permitted.
A specified PACE program may use marketing practices described in section 460.82(e)(5) of title 42, Code of Federal Regulations, as in effect on June 1, 2025.
Section 460.82(e)(5) of title 42, Code of Federal Regulations, is repealed and shall have no force or effect in law.
Section 5's amendments would apply to PACE marketing activities conducted starting 180 days after enactment.
The amendments made by subsection (a) shall apply with respect to marketing activities under section 1894 or 1934 of the Social Security Act (42 U.S.C. 1395eee; 1396u–4) conducted on or after the date that is 180 days after the date of the enactment of this Act.
Section 6 would replace provisions in both the Medicare and Medicaid PACE statutes with a requirement that the Secretary work closely with the state administering agency to establish procedures for starting, extending, and terminating program agreements with entities meeting the applicable provider requirements.
(a) Medicare Section 1894 of the Social Security Act (42 U.S.C. 1395eee) is amended
The Secretary, in close cooperation with the State administering agency, shall establish procedures for entering into, extending, and terminating PACE program agreements for the operation of PACE programs by entities that meet the requirements for a PACE provider under this section, section 1934, and regulations.
(b) Medicaid Section 1934 of the Social Security Act (42 U.S.C. 1396u–4) is amended
The Secretary, in close cooperation with the State administering agency, shall establish procedures for entering into, extending, and terminating PACE program agreements for the operation of PACE programs by entities that meet the requirements for a PACE provider under this section, section 1894, and regulations.
Section 6 would also replace paragraph (h)(2) in both statutes. Providers covered by those subsections would operate under the same terms and conditions as nonprofit private providers, except as provided in paragraph (h)(1). The supplied text does not reproduce that exception or identify the full category of providers covered by subsection (h).
in subsection (h), by striking paragraph (2) and inserting the following: (2) Similar terms and conditions Except as provided under paragraph (1), the terms and conditions for operation of a PACE program by a provider under this subsection shall be the same as those for PACE providers that are nonprofit, private organizations.
Section 6's amendments would take effect on enactment.
The amendments made by this section shall take effect on the date of the enactment of this Act.
The official-actions snapshot updated September 29, 2026, records introduction in the House on September 24, 2026, and referral that day to the Energy and Commerce and Ways and Means committees for provisions within their respective jurisdictions. This snapshot does not establish subsequent action or enactment.
Source snapshot updated 2026-09-29T15:13:46Z.
2026-09-24: Introduced in House
2026-09-24: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
A closer look
Reviewed version: Introduced in House · 2026-09-24. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy attached to appropriations was identified in the complete supplied introduced text. Its provisions concern PACE access and operation. This conclusion is limited to this version and does not establish what appears in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified in the complete supplied introduced text. This conclusion is limited to this version; formal earmark disclosures and accompanying materials were not supplied.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
Findings to examine
The supplied introduced text contains a conditional exemption from an application requirement for a defined subset of providers. This classification describes the preferential procedure, not its merits or origins.
Qualified PACE providers adding a center within an existing service area would receive a notice-based exemption from the application requirement. This benefit directly supports the bill's center-expansion policy. It would be limited to providers that have passed the program's first trial-period audit and are not subject to the specified sanctions, enforcement actions, or termination proceedings; the notice would also require state willingness to amend the agreement and assurances about location, staffing, and contracts.
A qualified PACE provider (as defined in subparagraph (E)(ii)) operating a PACE program in a service area that seeks to add a PACE center site under such PACE program to such service area (and does not also seek to expand its service area) shall not be required to submit an application to the Secretary in order to so add such PACE center site if the qualified PACE provider submits to the Secretary (at such time as the Secretary may specify in regulation) a qualifying notice (as defined in subparagraph (E)(i)) with respect to the proposed additional PACE center site.
a PACE provider that, at the time of submission of a qualifying notice to the Secretary— (I) has successfully completed the first trial period audit with respect to such PACE program; and (II) is not the subject of a sanction, an enforcement action or a termination proceeding under subpart D of part 460 of title 42, Code of Federal Regulations, or any successor regulation, with respect to such PACE program.
(I) An assurance that the additional PACE center site will be located within such service area of such PACE program. (II) An assurance from the State administering agency of the State in which the PACE program is located that the State is willing to amend the PACE program agreement to include the additional PACE center site in such service area. (III) Each of the assurances described in subparagraph (C)(ii).
(I) An assurance that the required members of the interdisciplinary team are employees or contractors of the proposed PACE center site or will be employees or contractors of the proposed PACE center site by the time the PACE center becomes operational. (II) An assurance that the PACE provider’s contracts for all contractors and contracted personnel will be executed by the time the proposed PACE center site becomes operational.
Full text preserved for this analysis. Legislative record snapshot: Sep 29, 2026. How PlainBill uses AI