[Federal Register Volume 74, Number 141 (Friday, July 24, 2009)]
[Notices]
[Pages 36722-36723]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-17607]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-5050-N]


Medicare and Medicaid Programs; Resolicitation of Proposals for 
the Private, For-Profit Demonstration Project for the Program of All-
Inclusive Care for the Elderly (PACE) and Announcement of Closing Date

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice.

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SUMMARY: This notice resolicits proposals for the private, for-profit 
demonstration project for the Program of All-Inclusive Care for the 
Elderly (PACE) and announces a closing date for the solicitation. We 
previously solicited proposals from private, for-profit organizations 
for a fully capitated joint Medicare and Medicaid demonstration.

DATES: Closing Date: Proposals must be submitted by July 26, 2010.

ADDRESSES: Proposals should be mailed to the following by the date 
specified in the DATES section of this notice: Attention: Michael 
Henesch, Office of Research, Development, and Information, Centers for 
Medicare and Medicaid Services, Mailstop: C4-17-27, 7500 Security 
Boulevard, Baltimore, MD 21244-1850.

FOR FURTHER INFORMATION CONTACT: Michael Henesch, 410-786-6685.

SUPPLEMENTARY INFORMATION:

I. Background

    Sections 1894(h)(1) and 1934(h)(1) of the Social Security Act (the 
Act) state that the Secretary shall grant waivers to enable up to ten 
private, for-profit Programs of All-Inclusive Care for the Elderly 
(PACE) demonstration projects to provide medical assistance to PACE 
program eligible individuals who are 55 years of age or older, require 
the level of care required for coverage of nursing facility services, 
and reside in the PACE program service area. The for-profit 
demonstration provision requires that, except for the numerical 
limitation of ten demonstration waivers, the operation of a PACE 
program by a provider shall be the same as those for PACE providers 
that are not-for-profit, private organizations. The purpose of this 
notice is to resolicit proposals for the private, for-profit 
demonstration project for the PACE and announces a closing date for the 
solicitation. A previous notice of solicitation to for-profit 
organizations (66 FR 42229) was published in the August 10, 2001 
Federal Register. The purpose of the August 2001 notice was to 
determine whether the risk-based long-term care model employed by the 
nonprofit PACE can be replicated successfully by for-profit 
organizations.
    Section 4804(b) of the Balanced Budget Act of 1997 (BBA) (Pub. L. 
105-33) requires issuance of a report that includes findings as to 
whether--
    <bullet> The number of covered lives enrolled in for-profit PACE 
demonstration projects are statistically sufficient to make the 
findings described below;
    <bullet> The population enrolled in for-profit PACE demonstration 
projects is less frail than the population enrolled with other PACE 
providers;
    <bullet> Access to or quality of care for individuals enrolled with 
for-profit PACE programs is lower than for those enrolled in other PACE 
programs; and
    <bullet> For-profit demonstration projects resulted in increased 
expenditures under Medicare or Medicaid programs above those incurred 
by other PACE providers.
    The August 2001 Federal Register (66 FR 42229), solicited proposals 
from for-profit entities to demonstrate that they can successfully 
provide comprehensive coordinated care for the frail elderly under a 
prepaid fully-capitated payment system. That notice specified that we 
would--(1) consider proposals only from for-profit organizations; and 
(2) operate the demonstration for 3 years.
    To date, there are only two for-profit PACE demonstration projects 
in place, both of which began in 2007.

II. Provisions of the Notice

    This notice resolicits proposals for the private, for-profit 
demonstration project for the PACE and announces a closing date for 
this solicitation. We publish this notice to--
    <bullet> Encourage for-profit entities to submit proposals to 
conduct projects to demonstrate the for-profit PACE concept over a 3 
year period, and to further encourage that they do so within the next 
year by establishing a closing date to the solicitation; and
    <bullet> Increase the number of covered enrollees across all for-
profit demonstration sites.
    Therefore, this notice provides an additional opportunity for 
interested

[[Page 36723]]

for-profit organizations to submit proposals to the address listed in 
the ADDRESSES section of this notice by the date specified in the DATES 
section of this notice. If after this limited 1-year opportunity the 
report with the required findings cannot be completed, for-profit PACE 
demonstrations should plan to terminate their projects. We note that, 
as a resolicitation, all proposals received will be evaluated using the 
criteria specified in the original August 10, 2001 Federal Register 
notice (66 FR 42231) and these criteria are also available on the CMS 
Web site at: http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?itemID=CMS1202809.

III. Collection of Information Requirements

    As we do not anticipate receiving 10 or more applications for this 
demonstration, this document does not impose information collection and 
recordkeeping requirements. Consequently, it need not be reviewed by 
the Office of Management and Budget under the authority of the 
Paperwork Reduction Act of 1995.

    Authority: Section 1894(h) and 1934(h) of the Social Security 
Act (42 U.S.C. 1395eee and 1396u-4) (Catalog of Federal Domestic 
Assistance Program No. 93.778, Medical Assistance Program; No. 
93.773 Medicare--Hospital Insurance Program; and No. 93.774, 
Medicare--Supplementary Medical Insurance Program)

    Dated: May 6, 2009.
Charlene Frizzera,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. E9-17607 Filed 7-23-09; 8:45 am]
BILLING CODE 4120-01-P