amounts for the provision of non-Medicare services 
under the PACE program to Medicare-only PACE 
program eligible individuals under a rate structure 
established by such PACE provider for such pur-
pose, including the use of an assessment instrument 
developed by the PACE program to assign such indi-
viduals to an appropriate rate category under such 
rate structure. 
‘‘(5) DEFINITIONS.—In this subsection— 
‘‘(A) the term ‘Medicare-only PACE pro-
gram eligible individual’ means an individual 
who is described in subsection (a)(1) and who 
is not entitled to medical assistance under title 
XIX, and includes the designated representative 
of the individual as appropriate; and 
‘‘(B) the term ‘non-Medicare services’ 
means items and services covered under title 
XIX that are not covered under this title and 
items and services described in subsection 
(b)(1)(A)(ii).’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect on the date of the enact-
ment of this Act, and apply with respect to capitation 
amounts that may be charged for months beginning on 
or after January 1, 2022. 
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(c) RULE OF CONSTRUCTION.—Nothing in this sec-
tion, or the amendments made by this section, shall be 
construed to modify or otherwise impact the following 
Medicare capitation rates that may be charged by PACE 
plans for PACE participants who are Medicare bene-
ficiaries who are not both entitled to (or enrolled for) bene-
fits under part A of title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.) and enrolled for benefits under 
part B of such title: 
(1) PART A ONLY MEDICARE BENEFICIARY.—In 
the case of a Medicare beneficiary who is a PACE 
participant who is entitled to (or enrolled for) bene-
fits under part A of such title XVIII but who is not 
enrolled for benefits under part B of such title, the 
Medicare Part B capitation rate under paragraph 
(b) of section 460.186 of title 42, Code of Federal 
Regulations (or any successor regulations). 
(2) PART B ONLY MEDICARE BENEFICIARY.—In 
the case of a Medicare beneficiary who is a PACE 
participant who is enrolled for benefits under part B 
of such title XVIII but who is not entitled to (or en-
rolled for) benefits under part A of such title, the 
Medicare Part A capitation rate under paragraph (c) 
of such section 460.186 (or any successor regula-
tions). 
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SEC. 6. PACE SITE APPROVAL AND EXPANSION. 
(a) IN GENERAL.—Sections 1894(e) and 1934(e) of 
the Social Security Act (42 U.S.C. 1395eee(e), 1396u– 
4(e)) are each amended by striking paragraph (8) and in-
serting the following: 
‘‘(8) AUTHORITY TO SUBMIT APPLICATIONS AT 
ANY
TIME; TIMELY
CONSIDERATION
OF
APPLICA-
TIONS.— 
‘‘(A) AUTHORITY
TO
SUBMIT
APPLICA-
TIONS AT ANY TIME.— 
‘‘(i) NEW PACE PROVIDER STATUS.— 
An entity that seeks to become a PACE 
provider may submit an application for 
PACE provider status at any time. 
‘‘(ii) SERVICE AREA EXPANSION AND 
ADDITION OF PACE CENTER SITE.—To the 
extent the Secretary requires a PACE pro-
vider to submit an application to expand 
its service area or to add a PACE center 
site, a PACE provider may submit such an 
application at any time, subject to the re-
quirements of section 460.12(d) of title 42, 
Code of Federal Regulations (relating to 
the first trial period audit), or any suc-
cessor regulation. 
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‘‘(iii) ASSURANCES.—An application 
for PACE provider status under clause (i) 
or to add a PACE center site under clause 
(ii) shall include the following assurances: 
‘‘(I) An assurance that the re-
quired members of the interdiscipli-
nary team are employees or contrac-
tors of the proposed PACE center or 
will be employees or contractors of the 
proposed PACE center by the time 
the PACE center becomes operational. 
‘‘(II) An assurance that— 
‘‘(aa) the PACE provider’s 
contracts for all contractors and 
contracted personnel will be exe-
cuted by the time the proposed 
PACE 
center 
becomes 
oper-
ational; and 
‘‘(bb) 
executed 
contracts 
may include provisions for staff-
ing levels to commensurate with 
enrollment to full projected cen-
sus. 
‘‘(B) DEEMED APPROVAL.—An application 
described in subparagraph (A) shall be deemed 
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approved unless the Secretary, within 45 days 
after the date of the submission of the applica-
tion 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 determina-
tion with respect to the application. After the 
date the Secretary receives such additional in-
formation, the application shall be deemed ap-
proved unless the Secretary, within 45 days of 
such date, denies such request.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect on January 1, 2022. 
SEC. 7. PACE PILOT. 
Section 1115A(b)(2) of the Social Security Act (42 
U.S.C. 1315a(b)(2)) is amended— 
(1) in subparagraph (B), by adding at the end 
the following new clause: 
‘‘(xxviii) National testing of a model 
for expanded eligibility for the Program of 
All-Inclusive Care for the Elderly as de-
scribed in subparagraph (D).’’; and 
(2) by adding at the end the following new sub-
paragraph: 
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