PACE Part D Choice Act of 2023

Where This Stands

Introduced

Committee

Floor Vote

Passed

Signed

Currently IN_COMMITTEE. The next step in the legislative lifecycle is Floor Vote.

Version history

Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.

View official text →

The Frame

What this does

This change impacts Medicare-only PACE enrollees who are not eligible for Medicaid by providing them the option to switch to a if it offers better financial terms, while requiring PACE providers to coordinate care and claims data with the new drug plan sponsors.

Who is mentioned in the record

Potentially affected actors named in the source documents. Mention is not a position.

Medicare-only PACE enrollees

They gain the legal right to elect a standalone prescription drug plan separate from their PACE program starting in 2025.

PACE providers

They must provide counseling, monitor drug utilization for enrollees who switch, and share claims data with standalone plan sponsors.

What changed

Current stage: IN_COMMITTEE.

What's next

Floor Vote.

Background

PACE (Program of All-Inclusive Care for the Elderly) is a Medicare and Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home or other care facility. context

Summary

This bill allows certain Medicare-only participants to choose a outside of their PACE program starting in 2025. It requires PACE providers to educate and assist these enrollees in comparing and selecting plans that offer lower out-of-pocket costs and federal subsidies.

Key Facts

You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.

Frequently Asked Questions

Who is eligible to switch to a standalone prescription drug plan under this bill?

Only 'applicable enrollees,' defined as individuals enrolled in a PACE program who are eligible for Medicare Part D but are not entitled to Medicaid ().

Can I switch to any prescription drug plan?

No, the plan must be a 'qualified ,' meaning it is not an , not operated by your current , and must be verified to have lower out-of-pocket costs and federal subsidies than your current PACE drug coverage.

What happens to my PACE program if I switch to a different drug plan?

You remain in the for other services, but the PACE program will no longer receive federal payments for your prescription drug coverage, and they are required to coordinate your care and claims data with your new drug plan sponsor.

Why It Matters

This change impacts Medicare-only PACE enrollees who are not eligible for Medicaid by providing them the option to switch to a if it offers better financial terms, while requiring PACE providers to coordinate care and claims data with the new drug plan sponsors.

News Coverage

No news coverage found yet. Articles are indexed twice daily.

Related Legislation

Federal Bill85% related

Proposed Review Process for Medicare Drug Coverage Denials

This bill creates a formal process for the federal government to review and potentially reverse Medicare coverage denials for specific drugs and biolo

Discoveries

Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.

policy shift90% confidence

Decoupling Drug Coverage from PACE

The bill represents a shift toward allowing PACE enrollees to unbundle their prescription drug coverage from the comprehensive PACE model, provided specific cost-saving criteria are met.

Social Security Act PACE program

Connected Entities

bill_numberH.R. 3549“bill_name”Map →

personBlumenauer“sponsor”Map →

organizationEnergy and Commerce Committee“committee”Map →

personSecretary“agency”Map →

personDingell“sponsor”Map →

organizationWays and Means Committee“committee”Map →

organizationU.S. Government Publishing Office“Source of the bill”Map →

personWenstrup“sponsor”Map →

Analysis Score

0–100

Significance65
How much this matters to a regular citizen
Controversy20
Intensity of disagreement among stakeholders
Entertainment5
Compellingness for a non-policy-wonk reader
Buzz15
Current news / social attention level