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(c)The objective of the PACE program is to provide…#
(c) The objective of the PACE program is to provide prepaid, capitated, quality comprehensive health care services that are designed to:
(i)Enhance the quality of life and autonomy for frail,…#
(i) Enhance the quality of life and autonomy for frail, older adults;
(ii)Maximize dignity of, and respect for, older adults;#
(ii) Maximize dignity of, and respect for, older adults;
(iii) Enable frail, older adults to live in the community as long as medically and socially feasible;
(iv) Preserve and support the older adult's family unit.
(d) The department shall adopt rules as necessary to implement this section. In adopting rules, the department shall:
(i) Provide application procedures for organizations seeking to become a PACE program provider;
(ii) Establish the capitation rate for Medicaid participants electing to participate in the PACE program instead of receiving Medicaid services on a fee for service basis. The capitation rate shall be no less than ninety percent (90%) of the fee for service equivalent cost, including the department's cost of administration, that the department estimates would be payable for all services covered under the PACE organization contract if all of those services were to be provided on a fee for service basis;
(iii) Provide application procedures, including acknowledgment of informed consent, for Medicaid participants electing to participate in the PACE program in lieu of receiving fee for service Medicaid benefits.
(e) PACE provider organizations shall be public or private organizations providing or having the capacity to provide, as determined by the department, comprehensive health care services on a risk based capitated basis to PACE patients.
(f) To demonstrate capacity as required by subsection (e) of this section, the department shall consider evidence such as an organization's insurance, reinsurance, cash reserves, letters