Page:United States Statutes at Large Volume 111 Part 1.djvu/553

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PUBLIC LAW 105-33 —AUG. 5, 1997 111 STAT. 529 "(2) PACE PROGRAM DEFINED.— For purposes of this section, the term 'PACE program' means a program of all-inclusive care for the elderly that meets the following requirements: "(A) OPERATION. — The entity operating the program is a PACE provider (as defined in paragraph (3)). "(B) COMPREHENSIVE BENEFITS. — The program provides comprehensive health care services to PACE program eligible individuals in accordance with the PACE program agreement and regulations under this section. "(C) TRANSITION.— In the case of an individual who is enrolled under the program under this section and whose enrollment ceases for any reason (including that the individual no longer qusJifies as a PACE program eligible individual, the termination of a PACE program agreement, or otherwise), the program provides assistance to the individual in obtaining necessary transitional care through appropriate referrals and making the individual's medical records available to new providers. "(3) PACE PROVIDER DEFINED.— "(A) IN GENERAL.— For purposes of this section, the term 'PACE provider' means an entity that— "(i) subject to subparagraph (B), is (or is a distinct part of) a public entity or a private, nonprofit entity organized for charitable purposes under section 501(c)(3) of the Internal Revenue Code of 1986; and "(ii) has entered into a PACE program agreement with respect to its operation of a PACE program. "(B) TREATMENT OF PRIVATE, FOR-PROFIT PROVIDERS.— Clause (i) of subparagraph (A) shall not apply— "(i) to entities subject to a demonstration project waiver under subsection (h); and "(ii) after the date the report under section 4804(b) of the Balanced Budget Act of 1997 is submitted, unless the Secretary determines that any of the findings described in subparagraph (A), (B), (C), or (D) of paragraph (2) of such section are true. "(4) PACE PROGRAM AGREEMENT DEFINED.— For purposes of this section, the term 'PACE program agreement' means, with respect to a PACE provider, an agreement, consistent with this section, section 1934 (if applicable), and regulations promulgated to carry out such sections, between the PACE provider and the Secretary, or an agreement between the PACE provider and a State administering agency for the operation of a PACE program by the provider under such sections. "(5) PACE PROGRAM ELIGIBLE INDIVIDUAL DEFINED.— For purposes of this section, the term 'PACE program eligible individual' means, with respect to a PACE program, an individual who— "(A) is 55 years of age or older; "(B) subject to subsection (c)(4), is determined under subsection (c) to require the level of care required under the State medicaid plan for coverage of nursing facility services; "(C) resides in the service area of the PACE program; and