Department of Community Health outlines Medicaid managed‑care shifts, PACE rollout and new state nurse‑aide proposal

The Department of Community Health told the House Human Relations & Aging Committee that an ongoing procurement to reassign certain Medicaid beneficiaries to care management organizations (CMOs) is under appeal and could take up to two years to resolve, delaying any operational changes until appeals and contract awards are final.

Committee members heard that the first population targeted for movement into CMOs are Social Security Administration SSI‑eligible individuals currently on fee‑for‑service Medicaid. Department officials said the initial shift is limited to that population. A later option in the request for proposals would allow the state, after two years of a new CMO contract, to consider moving elderly nursing‑home and waiver populations into managed care; officials said that option would require operational readiness and might not be exercised for several years.

Department officials also described a planned PACE (Program of All‑Inclusive Care for the Elderly) rollout. The department said it has completed actuarial work and an RFP with assistance from an experienced vendor; officials expect to seek proposals for multiple PACE centers and anticipate awarding geographic areas (zip codes)…