Relates to requirements for licensure of PACE organizations and to the authority of the commissioner of health to process applications for licensure of PACE organizations when regulations of such commissioner are pending.
STATE OF NEW YORK
________________________________________________________________________
11329
IN ASSEMBLY
May 11, 2026
___________
Introduced by COMMITTEE ON RULES -- (at request of M. of A. Paulin) --
read once and referred to the Committee on Health
AN ACT to amend the public health law, in relation to licensure of PACE
organizations
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 2999-u of the public health law, as amended by
2 chapter 90 of the laws of 2023, is amended to read as follows:
3 § 2999-u. Licensure. 1. The commissioner shall license an entity
4 applying for licensure as a PACE organization if the applicant demon-
5 strates to the satisfaction of the commissioner that the applicant will:
6 (a) comply with the requirements of a PACE organization under applica-
7 ble federal law and regulations;
8 (b) provide a facility or facilities at which primary care and other
9 services are furnished to enrollees;
10 (c) provide an interdisciplinary team approach to care management,
11 care delivery and care planning;
12 (d) comply with this article[, the applicable provisions of articles
13 twenty-eight, thirty-six and forty-four of this chapter and regulations
14 thereunder,] and regulations of the commissioner under this article; and
15 (e) enter into a PACE organization contract and agreement with the
16 department and CMS.
17 2. (a) A PACE organization shall serve an approved geographic service
18 area.
19 (b) A PACE organization and its incorporators, directors, sponsors,
20 stockholders, members, and operators shall have the experience, compe-
21 tence, and standing in the community as to give reasonable assurance of
22 their ability to operate the organization to provide a consistently high
23 level of care for enrollees and comply with this article. A PACE organ-
24 ization shall demonstrate that where any incorporator, director, spon-
25 sor, stockholder, member, or operator of the organization holds, or
26 within the past seven years has held, a controlling interest or been a
27 controlling person in an organization or facility licensed under this
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD15777-01-6
A. 11329 2
1 chapter, a consistently high level of care has been rendered in each
2 such organization or facility.
3 (c) A PACE organization shall not be required to meet requirements for
4 financial solvency [under paragraph (c) of subdivision one of section
5 forty-four hundred three of this chapter, including a contingent reserve
6 requirement which may, by regulations of the commissioner, be different
7 from that required by that paragraph] in excess of federal requirements
8 regarding fiscal soundness of PACE programs.
9 (d) A PACE organization shall be deemed to be a health maintenance
10 organization under article forty-four of this chapter for purposes of
11 subdivision one of section sixty-five hundred twenty-seven of the educa-
12 tion law.
13 3. (a) The commissioner shall establish in regulation a streamlined
14 and unified licensure process for PACE organizations that includes the
15 applicable program requirements of this article and [articles twenty-
16 eight, thirty-six and forty-four of this chapter] reflects applicable
17 federal regulations and process.
18 (b) A license under this article shall require approval of the public
19 health and health planning council.
20 § 2. Section 2999-y of the public health law, as amended by chapter 90
21 of the laws of 2023, is amended to read as follows:
22 § 2999-y. Regulations and applicable laws. 1. The commissioner shall
23 make regulations and take other actions reasonably necessary to imple-
24 ment this article, including the establishment of any rules and proc-
25 esses appropriate for the safe, efficient and orderly administration of
26 the program and for the maintenance and revocation of licensure under
27 this article. While awaiting finalization of regulations pursuant to
28 this article, the commissioner shall continue to process applications in
29 a timely manner and may apply policies regarding PACE that were in
30 effect prior to June thirtieth, two thousand twenty-three for such
31 applications except where such policies are in direct conflict with the
32 plain language of this article, as amended.
33 2. [(a)] Licensure granted under this article may, in accordance with
34 the approval by the commissioner, entitle the PACE organization to act
35 in the capacity and perform the activities of a diagnostic and treatment
36 center, home care services agency, health maintenance organization, or
37 managed long term care plan for which licensure or certification is
38 otherwise required under article twenty-eight, thirty-six, or forty-four
39 of this chapter as applicable without such separate license or certif-
40 ication for purposes relating to the PACE.
41 [(b) To the extent that a PACE organization is acting in the capacity
42 or performing an activity for which licensure or certification is other-
43 wise required under article twenty-eight, thirty-six, or forty-four of
44 this chapter, the PACE organization shall comply with the applicable
45 requirements of such articles and any applicable regulations adopted
46 thereunder; except that where such requirements are inconsistent with
47 the requirements of this article or regulations adopted by the commis-
48 sioner under this article, the requirements of this article and such
49 regulations shall apply.]
50 3. The commissioner may apply for federal waivers under Medicaid or
51 demonstration programs under Medicare relating to the PACE program,
52 provided that the waiver or demonstration shall not diminish any right
53 or benefit of enrollees under this article.
54 § 3. This act shall take effect immediately.
