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BEM 167 1 of 5 PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY (PACE) BPB 2023-013 7-1-2023

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

DEPARTMENT POLICY MA Only The Program of All Inclusive Care for the Elderly (PACE) is a man- aged care program designed for the frail, elderly population. PACE enrollment is always prospective. The Medicaid Services Administration (MSA) administers the program through contracts with PACE organizations. The PACE organization receives referrals from medical providers in the community who believe a person meets both the PACE program and Medicaid eligibility factors in this item as well as the nursing facility level of care criteria. PACE is currently operating in several counties in southern Michigan. The PACE program is not a Medicaid category, but there are spe- cial eligibility rules for clients approved for PACE services. TARGETED GROUP The person must meet all the following: • Be medically qualified. • Be 55 years of age or older. • Live within an approved geographic area of the PACE provider. • Not reside in a nursing facility at the time of enrollment. • Not enrolled in the MIChoice Waiver. • Not enrolled in an HMO. NONFINANCIAL ELIGIBILITY FACTORS The eligibility factors in the following items must be met. • BEM 220, Residence. • BEM 221, Identity. • BEM 223, Social Security Numbers. • BEM 225, Citizenship/Alien Status. • BEM 255, Child Support. • BEM 256, Spousal/Parental Support. • BEM 257, Third Party Resource Liability. • BEM 265, Institutional Status. • BEM 270, Pursuit of Benefits.

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Official source

BEM 167 1 of 5 PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY (PACE) BPB 2023-013 7-1-2023

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

DEPARTMENT POLICY MA Only The Program of All Inclusive Care for the Elderly (PACE) is a man- aged care program designed for the frail, elderly population. PACE enrollment is always prospective. The Medicaid Services Administration (MSA) administers the program through contracts with PACE organizations. The PACE organization receives referrals from medical providers in the community who believe a person meets both the PACE program and Medicaid eligibility factors in this item as well as the nursing facility level of care criteria. PACE is currently operating in several counties in southern Michigan. The PACE program is not a Medicaid category, but there are spe- cial eligibility rules for clients approved for PACE services. TARGETED GROUP The person must meet all the following: • Be medically qualified. • Be 55 years of age or older. • Live within an approved geographic area of the PACE provider. • Not reside in a nursing facility at the time of enrollment. • Not enrolled in the MIChoice Waiver. • Not enrolled in an HMO. NONFINANCIAL ELIGIBILITY FACTORS The eligibility factors in the following items must be met. • BEM 220, Residence. • BEM 221, Identity. • BEM 223, Social Security Numbers. • BEM 225, Citizenship/Alien Status. • BEM 255, Child Support. • BEM 256, Spousal/Parental Support. • BEM 257, Third Party Resource Liability. • BEM 265, Institutional Status. • BEM 270, Pursuit of Benefits.