II 

117TH CONGRESS 

2D SESSION S. 3626 

To improve access to the Program of All-Inclusive Care for the Elderly, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 10, 2022 

Mr. CASEY (for himself and Mr. SCOTT of South Carolina) introduced the 

following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To improve access to the Program of All-Inclusive Care 

for the Elderly, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Program of All-inclu5 sive Care for the Elderly Expanded Act’’ or the ‘‘PACE 

6 Expanded Act’’. 


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1 SEC. 2. IMPROVING ACCESS TO AND AFFORDABILITY OF 

2 PACE PROGRAMS FOR MEDICARE BENE3 FICIARIES WHO ARE NOT DUAL ELIGIBLE 

4 BENEFICIARIES THROUGH FLEXIBILITY IN 

5 RATE SETTING FOR SERVICES NOT COVERED 

6 BY MEDICARE. 

7 (a) IN GENERAL.—Section 1894 of the Social Secu8 rity Act (42 U.S.C. 1395eee) is amended by adding at the 

9 end the following new subsection: 

10 ‘‘(j) FLEXIBILITY IN ESTABLISHING PREMIUMS FOR

11 MEDICARE PACE PARTICIPANTS WHO ARE NOT ALSO

12 ENTITLED TO BENEFITS UNDER A STATE MEDICAID

13 PROGRAM.— 

14 ‘‘(1) CODIFICATION OF AUTHORITY TO CHARGE

15 A MONTHLY CAPITATION AMOUNT FOR NON-MEDI16 CARE SERVICES.—Subject to the succeeding provi17 sions of this subsection, a PACE program operated 

18 by a PACE provider under a PACE program agree19 ment in any State may charge a Medicare-only 

20 PACE program eligible individual (as defined in 

21 paragraph (4)(A)) who is enrolled in such PACE 

22 program a monthly capitation payment amount for 

23 the provision of non-Medicare services (as defined in 

24 paragraph (4)(B)) under the PACE program. 

25 ‘‘(2) DETERMINATION OF MONTHLY CAPITA26 TION PAYMENT AMOUNT.— 


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1 ‘‘(A) IN GENERAL.—Notwithstanding sec2 tion 460.186 of title 42, Code of Federal Regu3 lations (or any successor regulation), the 

4 monthly capitation payment amount that may 

5 be charged under paragraph (1) shall be deter6 mined by the PACE provider operating the 

7 PACE program. Such monthly capitation pay8 ment amount shall be based on assessments 

9 conducted on the Medicare-only PACE program 

10 eligible individual who is enrolled in such PACE 

11 program by the PACE program interdiscipli12 nary team and shall take into account the 

13 health status of such individual. In determining 

14 the monthly capitation amount for a Medicare15 only PACE program eligible individual under 

16 this paragraph, a PACE provider may take into 

17 account the services determined necessary for 

18 the individual by the PACE program inter19 disciplinary team based upon their assessment 

20 of the individual. A determination described in 

21 the preceding sentence shall not be construed as 

22 limiting the responsibility of the PACE provider 

23 to meet any unforeseen needs or provide for any 

24 required services for such individual. 


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1 ‘‘(B) AUTHORITY TO ADJUST MONTHLY

2 CAPITATION AMOUNT.— 

3 ‘‘(i) IN GENERAL.—Subject to clause 

4 (ii) and paragraph (3), the monthly capita5 tion payment amount that may be charged 

6 under paragraph (1) to a Medicare-only 

7 PACE program eligible individual enrolled 

8 in a PACE program for non-Medicare 

9 services may increase or decrease based on 

10 assessments conducted on such individual. 

11 Any change in the monthly capitation pay12 ment amount charged to such an indi13 vidual shall take effect beginning with the 

14 first day of the first month that begins 

15 after the month during which the plan of 

16 care is developed for such individual based 

17 on such an assessment. 

18 ‘‘(ii) LIMITATION ON FREQUENCY OF

19 INCREASE.—The monthly capitation pay20 ment amount that may be charged under 

21 paragraph (1) to such an individual may 

22 not increase more frequently than once per 

23 calendar quarter. 

24 ‘‘(3) BENEFICIARY PROTECTIONS.— 


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1 ‘‘(A) DISCLOSURE OF PREMIUM RATE

2 STRUCTURE.—A PACE provider shall disclose 

3 to Medicare-only PACE program eligible indi4 viduals the capitation payment amounts that 

5 may be charged under this section to such indi6 viduals for non-Medicare services under the 

7 PACE program operated by such PACE pro8 vider under this section— 

9 ‘‘(i) prior to enrollment of such indi10 vidual in such PACE program, and 

11 ‘‘(ii) periodically, and upon request of 

12 such individual, after enrollment. 

13 ‘‘(B) ASSESSMENT INSTRUMENT.— 

14 ‘‘(i) IN GENERAL.—The Secretary 

15 shall develop an assessment instrument for 

16 use by PACE programs with respect to 

17 Medicare-only PACE program eligible indi18 viduals under this subsection. 

19 ‘‘(ii) REQUIREMENT FOR DISCLOSURE

20 OF ASSESSMENT INSTRUMENT.—The 

21 monthly capitation payment amount 

22 charged under paragraph (1) to a Medi23 care-only PACE program eligible individual 

24 for non-Medicare services shall be based on 

25 an assessment of such individual conducted 


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1 by the PACE provider (using the assess2 ment instrument developed by the Sec3 retary under clause (i)), accounting for 

4 health status and corresponding needs. 

5 ‘‘(iii) REQUIREMENT FOR DISCLOSURE

6 OF ASSESSMENT INSTRUMENT.—The as7 sessment instrument used by the inter8 disciplinary team of the PACE program to 

9 evaluate the health and social status of 

10 PACE participants shall be disclosed to 

11 the individual prior to the assessment. 

12 ‘‘(C) PROCESS TO SEEK REVIEW OF AS13 SESSMENTS.—The Secretary shall establish a 

14 process for a Medicare-only PACE program eli15 gible individual to seek review of any assess16 ment conducted on the individual under this 

17 subsection. 

18 ‘‘(4) RULE OF CONSTRUCTION.—Nothing in 

19 this subsection shall be construed to preclude the 

20 testing under section 1115A of a model to permit a 

21 PACE provider operating a PACE program to es22 tablish and charge monthly capitation payment 

23 amounts for the provision of non-Medicare services 

24 under the PACE program to Medicare-only PACE 

25 program eligible individuals under a rate structure 


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1 established by such PACE provider for such pur2 pose, including the use of an assessment instrument 

3 developed by the PACE program to assign such indi4 viduals to an appropriate rate category under such 

5 rate structure. 

6 ‘‘(5) DEFINITIONS.—In this subsection— 

7 ‘‘(A) the term ‘Medicare-only PACE pro8 gram eligible individual’ means an individual 

9 who is described in subsection (a)(1) and who 

10 is not entitled to medical assistance under title 

11 XIX, and includes the designated representative 

12 of the individual as appropriate; and 

13 ‘‘(B) the term ‘non-Medicare services’ 

14 means items and services covered under title 

15 XIX that are not covered under this title and 

16 items and services described in subsection 

17 (b)(1)(A)(ii).’’. 

18 (b) EFFECTIVE DATE.—The amendment made by 

19 subsection (a) shall take effect on the date of the enact20 ment of this Act, and apply with respect to capitation 

21 amounts that may be charged for months beginning on 

22 or after January 1, 2023. 

23 (c) RULE OF CONSTRUCTION.—Nothing in this sec24 tion, or the amendments made by this section, shall be 

25 construed to modify or otherwise impact the following 


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1 Medicare capitation rates that may be charged by PACE 

2 plans for PACE participants who are Medicare bene3 ficiaries who are not both entitled to (or enrolled for) bene4 fits under part A of title XVIII of the Social Security Act 

5 (42 U.S.C. 1395 et seq.) and enrolled for benefits under 

6 part B of such title: 

7 (1) PART A ONLY MEDICARE BENEFICIARY.—In 

8 the case of a Medicare beneficiary who is a PACE 

9 participant who is entitled to (or enrolled for) bene10 fits under part A of such title XVIII but who is not 

11 enrolled for benefits under part B of such title, the 

12 Medicare Part B capitation rate under paragraph 

13 (b) of section 460.186 of title 42, Code of Federal 

14 Regulations (or any successor regulations). 

15 (2) PART B ONLY MEDICARE BENEFICIARY.—In 

16 the case of a Medicare beneficiary who is a PACE 

17 participant who is enrolled for benefits under part B 

18 of such title XVIII but who is not entitled to (or en19 rolled for) benefits under part A of such title, the 

20 Medicare Part A capitation rate under paragraph (c) 

21 of such section 460.186 (or any successor regula22 tions). 

23 SEC. 3. ANYTIME ENROLLMENT IN PACE. 

24 (a) IN GENERAL.— 


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1 (1) ANY TIME ENROLLMENT AND EFFECTIVE

2 DATE.—Section 1894(c)(5) of the Social Security 

3 Act (42 U.S.C. 1395eee(c)(5)) is amended by adding 

4 at the end the following new subparagraph: 

5 ‘‘(C) ANY TIME ENROLLMENT AND EFFEC6 TIVE DATE OF ENROLLMENT.— 

7 ‘‘(i) ANY TIME ENROLLMENT.—A 

8 PACE program eligible individual may en9 roll in a PACE program at any time dur10 ing a month. 

11 ‘‘(ii) EFFECTIVE DATE.—Subject to 

12 clause (iii), the enrollment of a PACE pro13 gram eligible individual in a PACE pro14 gram shall be effective on the date the 

15 PACE provider operating the PACE pro16 gram receives an enrollment agreement 

17 signed by such PACE program eligible in18 dividual with respect to such PACE pro19 gram. 

20 ‘‘(iii) SPECIAL RULE IN THE CASE OF

21 DUAL ELIGIBLE BENEFICIARIES.—In the 

22 case of a PACE program eligible individual 

23 who is eligible for benefits under this title 

24 and title XIX, clause (i) shall only apply if 

25 the State in which such individual resides 


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1 has made an election under section 

2 1934(c)(5)(C) to permit PACE program 

3 eligible individuals enroll in a PACE pro4 gram at any time during a month in such 

5 State.’’. 

6 (2) PRORATED PAYMENTS.—Section 1894(d) of 

7 the Social Security Act (42 U.S.C. 1395eee(d)) is 

8 amended by adding at the end the following new 

9 paragraph: 

10 ‘‘(4) PRORATED PAYMENTS.—In the case of a 

11 PACE program eligible individual enrolled in a 

12 PACE program operated by a PACE provider with 

13 an enrollment effective date that is not the first day 

14 of a month, the capitation amount that would other15 wise be made under this subsection to the PACE 

16 provider for such individual for the first month in 

17 which such individual is so enrolled shall be prorated 

18 accordingly.’’. 

19 (b) CONFORMING AMENDMENTS.— 

20 (1) ANYTIME ENROLLMENT AND EFFECTIVE

21 DATE.—Section 1934(c)(5) of the Social Security 

22 Act (42 U.S.C. 1396u–4(c)(5)) is amended by add23 ing at the end the following new subparagraph: 


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1 ‘‘(C) STATE OPTION TO PERMIT ANY TIME

2 ENROLLMENT AND EFFECTIVE DATE OF EN3 ROLLMENT.— 

4 ‘‘(i) ANY TIME ENROLLMENT.—A 

5 State may elect to permit a PACE pro6 gram eligible individual to enroll in a 

7 PACE program at any time during a 

8 month. 

9 ‘‘(ii) EFFECTIVE DATE.—Pursuant to 

10 a State election made under clause (i), the 

11 enrollment of a PACE program eligible in12 dividual in a PACE program shall be effec13 tive on the date the PACE provider oper14 ating the PACE program receives an en15 rollment agreement signed by such PACE 

16 program eligible individual with respect to 

17 such PACE program.’’. 

18 (2) PRORATED PAYMENTS.—Section 1934(d) of 

19 the Social Security Act (42 U.S.C. 1396u–4(d)) is 

20 amended by adding at the end the following new 

21 paragraph: 

22 ‘‘(3) PRORATED PAYMENTS.—If a State elects 

23 under subsection (c)(5)(C) to permit enrollment at 

24 any time during a month, in the case of a PACE 

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1 gram operated by a PACE provider with an enroll2 ment effective date that is not the first day of a 

3 month, the State shall prorate the capitation amount 

4 that would otherwise be made under this subsection 

5 to the PACE provider for such individual for the 

6 first month in which such individual is so enrolled.’’. 

7 (c) EFFECTIVE DATE.—The amendments made by 

8 this section shall take effect on January 1, 2023. 

9 SEC. 4. PACE SITE APPROVAL AND EXPANSION. 

10 (a) IN GENERAL.—Sections 1894(e) and 1934(e) of 

11 the Social Security Act (42 U.S.C. 1395eee(e), 1396u– 

12 4(e)) are each amended by striking paragraph (8) and in13 serting the following: 

14 ‘‘(8) AUTHORITY TO SUBMIT APPLICATIONS AT

15 ANY TIME; TIMELY CONSIDERATION OF APPLICA16 TIONS.— 

17 ‘‘(A) AUTHORITY TO SUBMIT APPLICA18 TIONS AT ANY TIME.— 

19 ‘‘(i) NEW PACE PROVIDER STATUS.— 

20 An entity that seeks to become a PACE 

21 provider may submit an application for 

22 PACE provider status at any time. 

23 ‘‘(ii) SERVICE AREA EXPANSION AND

24 ADDITION OF PACE CENTER SITE.—To the 

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1 vider to submit an application to expand 

2 its service area or to add a PACE center 

3 site, a PACE provider may submit such an 

4 application at any time, subject to the re5 quirements of section 460.12(d) of title 42, 

6 Code of Federal Regulations (relating to 

7 the first trial period audit), or any suc8 cessor regulation. 

9 ‘‘(iii) ASSURANCES.—An application 

10 for PACE provider status under clause (i) 

11 or to add a PACE center site under clause 

12 (ii) shall include the following assurances: 

13 ‘‘(I) An assurance that the re14 quired members of the interdiscipli15 nary team are employees or contrac16 tors of the proposed PACE center or 

17 will be employees or contractors of the 

18 proposed PACE center by the time 

19 the PACE center becomes operational. 

20 ‘‘(II) An assurance that— 

21 ‘‘(aa) the PACE provider’s 

22 contracts for all contractors and 

23 contracted personnel will be exe24 cuted by the time the proposed 


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1 PACE center becomes oper2 ational; and 

3 ‘‘(bb) executed contracts 

4 may include provisions for staff5 ing levels commensurate with en6 rollment to full projected census. 

7 ‘‘(B) DEEMED APPROVAL.—An application 

8 described in subparagraph (A) shall be deemed 

9 approved unless the Secretary, within 45 days 

10 after the date of the submission of the applica11 tion to the Secretary, either denies such request 

12 in writing or informs the applicant in writing 

13 with respect to any additional information that 

14 is needed in order to make a final determina15 tion with respect to the application. After the 

16 date the Secretary receives such additional in17 formation, the application shall be deemed ap18 proved unless the Secretary, within 45 days of 

19 such date, denies such request.’’. 

20 (b) EFFECTIVE DATE.—The amendments made by 

21 subsection (a) shall take effect on January 1, 2023. 

22 SEC. 5. PACE PILOT. 

23 Section 1115A(b)(2) of the Social Security Act (42 

24 U.S.C. 1315a(b)(2)) is amended— 


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1 (1) in subparagraph (B), by adding at the end 

2 the following new clause: 

3 ‘‘(xxviii) National testing of a model 

4 for expanded eligibility for the Program of 

5 All-Inclusive Care for the Elderly as de6 scribed in subparagraph (D).’’; and 

7 (2) by adding at the end the following new sub8 paragraph: 

9 ‘‘(D) NATIONAL TESTING OF MODEL FOR

10 EXPANDED ELIGIBILITY FOR THE PROGRAM OF

11 ALL-INCLUSIVE CARE FOR THE ELDERLY.—In 

12 the case where the Secretary selects the model 

13 described in clause (ii) of this subparagraph for 

14 testing pursuant to clause (xxviii) of subpara15 graph (B), the following shall apply: 

16 ‘‘(i) NATIONAL TESTING.— 

17 ‘‘(I) IN GENERAL.—Subject to 

18 subclause (II), the Secretary shall de19 sign a demonstration that allows each 

20 PACE provider with an executed 

21 PACE agreement to develop and sub22 mit to the Secretary an application to 

23 begin testing expanded PACE eligi24 bility for high-need and high-cost pop25 ulations that are not otherwise eligible 


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1 to participate in a PACE program 

2 within 1 year of the date on which the 

3 model is selected. 

4 ‘‘(II) NO EFFECT ON ONGOING

5 MODELS OR DEMONSTRATION

6 PROJECTS.—Nothing in this subpara7 graph shall affect the testing of any 

8 model under this subsection or any 

9 demonstration project under this Act 

10 that is implemented prior to the date 

11 of the enactment of this subpara12 graph. 

13 ‘‘(ii) MODEL DESCRIBED.—The model 

14 described in this clause seeks to increase 

15 access to quality, integrated, care for high16 need, high-cost individuals who are not 

17 otherwise eligible to participate in a PACE 

18 program in order to improve health and re19 duce cost. Under this model, participating 

20 PACE providers would— 

21 ‘‘(I) be paid fixed, monthly 

22 capitated rates from both Medicare 

23 and the applicable State Medicaid 

24 agency for all services provided to 

25 each enrollee fitting the criteria of the 


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1 PACE provider’s designated popu2 lation; 

3 ‘‘(II) partner with non-PACE 

4 providers, such as Area Agencies on 

5 Aging, Centers for Independent Liv6 ing, local hospitals, and non-hospital 

7 providers such as physicians, behav8 ioral health providers and other com9 munity-based organizations to effec10 tively reach the PACE provider’s se11 lected population; 

12 ‘‘(III) adapt the PACE program 

13 model of care to appropriately serve 

14 the PACE provider’s selected popu15 lation to integrate care and meet the 

16 unique needs of said population; and 

17 ‘‘(IV) if the PACE provider is lo18 cated in a State that has not yet 

19 served the selected population through 

20 a PACE program under section 1934, 

21 receive an up-front fixed payment to 

22 coordinate with the State to develop a 

23 capitated payment rate, with appro24 priate risk adjustment, for the PACE 

25 provider’s selected population. 


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1 ‘‘(iii) REQUIREMENTS FOR PARTICI2 PATING PACE ORGANIZATIONS.—In order 

3 to participate in the model, a PACE pro4 vider must— 

5 ‘‘(I) conduct a survey or needs 

6 assessment of their service area to de7 termine the most appropriate popu8 lation with which to expand their serv9 ices; 

10 ‘‘(II) receive prior approval from 

11 the applicable State Medicaid agency 

12 to submit an application to participate 

13 in the model; and 

14 ‘‘(III) following such survey or 

15 needs assessment and approval from 

16 the applicable State Medicaid agency, 

17 submit and receive approval of an ap18 plication of expansion from the Sec19 retary. 

20 ‘‘(iv) APPLICATION.—A PACE pro21 vider’s application to participate in this 

22 model shall include the following informa23 tion: 

24 ‘‘(I) Results of the survey or 

25 needs assessment of their service area 


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1 under clause (iii)(I) and an expla2 nation of the expanded population the 

3 PACE organization will serve. 

4 ‘‘(II) The types of services that 

5 the expanded population will require 

6 and the PACE provider’s plan to im7 plement these services. 

8 ‘‘(III) How the PACE provider 

9 will achieve engagement and enroll10 ment of the new population in the 

11 model, including how it will partner 

12 with non-PACE providers in the ap13 plicable service area. 

14 ‘‘(IV) How the expanded popu15 lation’s participation in the PACE 

16 program is intended to improve qual17 ity of care and health outcomes under 

18 the model. 

19 ‘‘(V) Certification that the appli20 cable State Medicaid agency has ap21 proved the PACE provider’s applica22 tion to participate in the model. 

23 ‘‘(VI) Plans to coordinate with 

24 the State Medicaid agency to develop 


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1 an initial capitated rate with appro2 priate risk adjustment. 

3 ‘‘(VII) Plans for the PACE pro4 vider and the State Medicaid agency 

5 to review and adjust the Medicaid 

6 capitated rate on a biennial basis, as 

7 needed. 

8 ‘‘(VIII) Any other information 

9 required by the Secretary. 

10 ‘‘(v) TECHNICAL ASSISTANCE.—The 

11 Secretary shall provide, or designate an en12 tity to provide, technical assistance to par13 ticipating PACE providers as they apply 

14 for and implement the model. 

15 ‘‘(vi) ACCOUNTING FOR UNCER16 TAINTY.—In order for implementing 

17 PACE providers to receive unanticipated 

18 additional resources needed to implement 

19 the model, the Secretary shall establish 

20 procedures for the implementing PACE 

21 providers to submit to the Secretary a re22 quest for additional resources. 

23 ‘‘(vii) MONITORING OUTCOMES.—The 

24 Secretary, in conjunction with PACE pro25 viders and in consultation with States that 


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1 have elected to expand PACE program eli2 gibility under section 1934(l), shall develop 

3 a plan to— 

4 ‘‘(I) annually monitor outcomes 

5 under the model, which may include 

6 financial, quality, access, and utiliza7 tion outcomes; 

8 ‘‘(II) annually monitor the health 

9 outcomes of the PACE provider’s ex10 panded population; and 

11 ‘‘(III) any other outcomes as de12 termined by the Secretary. 

13 ‘‘(viii) REPORTING REQUIREMENTS.— 

14 ‘‘(I) REPORT TO CONGRESS.— 

15 Not less frequently than every 3 years 

16 (for the duration of the implementa17 tion of the model under this subpara18 graph), the Secretary shall submit to 

19 Congress a report on the implementa20 tion of the model under this subpara21 graph. The report shall include demo22 graphic information on the popu23 lations served under the demonstra24 tion, best practices for future imple25 mentation efforts and any other inforVerDate Sep 11 2014 00:08 Feb 17, 2022 Jkt 029200 PO 00000 Frm 00021 Fmt 6652 Sfmt 6201 E:\BILLS\S3626.IS S3626

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1 mation the Secretary determines ap2 propriate together with recommenda3 tions for such legislation and adminis4 trative action as the Secretary deter5 mines appropriate. 

6 ‘‘(ix) FUNDING.—The Secretary shall 

7 allocate funds made available under sub8 section (f)(1) to design, implement, evalu9 ate, and report on the model described in 

10 clause (ii) in accordance with this subpara11 graph.’’. 

12 SEC. 6. COORDINATION WITH THE FEDERAL COORDINATED 

13 HEALTH CARE OFFICE. 

14 Section 1934 of the Social Security Act (42 U.S.C. 

15 1396u–4), as amended by sections 3 and 8, is amended 

16 by adding at the end the following new subsection: 

17 ‘‘(m) COORDINATION WITH THE FEDERAL COORDI18 NATED HEALTH CARE OFFICE.— 

19 ‘‘(1) STATE COORDINATION WITH FCHCO.—The 

20 Director of the Federal Coordinated Health Care Of21 fice established under section 2602 of the Patient 

22 Protection and Affordable Care Act shall serve as a 

23 point of contact between State administering agen24 cies and the Federal Government for purposes of im25 plementing and operating a PACE program in a 


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1 State, and shall coordinate with other relevant of2 fices and staff of the Centers for Medicare & Med3 icaid Services involved in carrying out this section. 

4 ‘‘(2) ANNUAL REPORT.—Not later than Janu5 ary 1, 2023, and annually thereafter, the Director of 

6 the Federal Coordinated Health Care Office shall 

7 submit to Congress a report on the demographics of 

8 the populations served by PACE programs operated 

9 under this section and section 1894.’’. 

10 SEC. 7. EVALUATION OF EFFECTIVENESS OF PACE PRO11 GRAM IN RURAL AND UNDERSERVED AREAS. 

12 (a) IN GENERAL.—The Assistant Secretary for Plan13 ning and Evaluation of the Department of Health and 

14 Human Services (referred to in this section as the ‘‘Assist15 ant Secretary’’) shall conduct an evaluation of the effec16 tiveness of the program for all-inclusive care for the elder17 ly under sections 1894 and 1934 of the Social Security 

18 Act (42 U.S.C. 1395eee, 1396u–4) in rural and under19 served areas, including with respect to the following fac20 tors: 

21 (1) Reductions in hospitalizations and re-hos22 pitalizations among program beneficiaries. 

23 (2) Reductions in emergency department use 

24 among program beneficiaries. 


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1 (3) Reductions in long-term nursing facility use 

2 among program beneficiaries. 

3 (4) Reductions in mortality among program 

4 beneficiaries. 

5 (5) Achieving lower rates of functional decline, 

6 and improvements in reported health status and 

7 quality of life among program beneficiaries. 

8 (6) Reductions in the total cost of care among 

9 program beneficiaries. 

10 (7) The effect of activities supported under the 

11 program on the local area serviced by the program, 

12 including on the health and well-being of unpaid and 

13 family caregivers of program beneficiaries. 

14 (8) Improvements in quality of life among pro15 gram beneficiaries. 

16 (b) REPORT.—Not later than 60 months after the 

17 date of enactment of this Act, the Assistant Secretary 

18 shall submit a report containing the results of the evalua19 tion required under subsection (a), an analysis of which 

20 elements of the program for all-inclusive care for the elder21 ly under sections 1894 and 1934 of the Social Security 

22 Act (42 U.S.C. 1395eee, 1396u–4) should be replicated 

23 and scaled by governmental or non-governmental entities, 

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1 priate to the chairs and ranking members of the following 

2 committees: 

3 (1) The Special Committee on Aging of the 

4 Senate. 

5 (2) The Committee on Finance of the Senate. 

6 (3) The Committee on Health, Education, 

7 Labor, and Pensions of the Senate. 

8 (4) The Committee on Ways and Means of the 

9 House of Representatives. 

10 (5) The Committee on Energy and Commerce 

11 of the House of Representatives. 

12 (c) PARTNERS.—In conducting the evaluation and 

13 completing the report required under this section, the As14 sistant Secretary shall provide an opportunity for partners 

15 and persons that have participated in the program for all16 inclusive care for the elderly under sections 1894 and 

17 1934 of the Social Security Act (42 U.S.C. 1395eee, 

18 1396u–4) on every level, especially individuals who receive 

19 care through the program and their unpaid or family care20 givers, to have an opportunity to contribute their expertise 

21 to evaluating the strategy and outcomes of the program. 

Æ 


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