State Plan Amendments for PACE

Before CMS can enter into a PACE program agreement with a provider and state, the state must amend their Medicaid State Plan to include PACE.  CMS has developed a preprint page that state can use for this process or states can develop an alternative format.  The State plan must also be amended/updated each time the State changes the maximum number of participants to be served in the program or wishes to revise the approved PACE provisions in its State plan.

The State plan amendment covers three major components:

• Clinical and financial eligibility and post-eligibility treatment of income requirements for PACE enrollees
• An overview of the methodology used to calculate the Medicaid capitated payments
• Procedures for process Medicaid enrollments and disenrollments in the State's management information system.

For more information on the State Plan Amendment, click here.   For more information for State Agencies from CMS, click here.

The following are links to approved State Plan Amendments pertaining to PACE.  Click on the state name to review the document.  (Note:  States that appear but are not linked are currently being researched and will be updated as soon as possible.)

• Arkansas

• California  

• Colorado
• Florida (Section 3) (Attachment 3.1-A) (Attachment 3.1-B)
• Illinois
• Iowa
• Kansas
• Massachusetts
• Michigan
• Maryland (May 24, 2002 Complete SPA) (January 27, 2003 Updated SPA)
• Missouri
• New Mexico
• New Jersey
• New York (Report, Report 2, Updated SPA)
• Ohio
• Oregon
• Pennsylvania
• South Carolina
• Tennessee
• Texas
• Virginia
• Washington
• Wisconsin