PACE PROGRAM-COOK COUNTY

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB4192

Introduced 4/28/2026, by Sen. Sara Feigenholtz

SYNOPSIS AS INTRODUCED:

320 ILCS 40/15

from Ch. 23, par. 6915

Amends the Program of All-Inclusive Care for the Elderly Act.
Provides that the geographic area consisting of the following zip codes in
Cook County shall be a designated service area under the Program of
All-Inclusive Care for the Elderly program: 60610, 60613,60614, 60640, and
60657.
LRB104 21496 KTG 36788 b

A BILL FOR

SB4192
LRB104 21496 KTG 36788 b
1

AN ACT concerning aging.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Program of All-Inclusive Care for the
5
Elderly Act is amended by changing Section 15 as follows:

6

(320 ILCS 40/15)

(from Ch. 23, par. 6915)
7

Sec. 15.
Program implementation.
8

(a) The Department of Healthcare and Family Services must
9
prepare and submit a PACE State Plan amendment no later than
10
December 31, 2022 to the federal Centers for Medicare and
11
Medicaid Services to establish the Program of All-Inclusive
12
Care for the Elderly (PACE program) to provide
13
community-based, risk-based, and capitated long-term care
14
services as optional services under the Illinois Title XIX
15
State Plan and under contracts entered into between the
16
federal Centers for Medicare and Medicaid Services, the
17
Department of Healthcare and Family Services, and PACE
18
organizations, meeting the requirements of the Balanced Budget
19
Act of 1997 (Public Law 105-33) and any other applicable law or
20
regulation.
21

(b) The Department of Healthcare and Family Services shall
22
facilitate the PACE organization application process no later
23
than December 31, 2023.

SB4192
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LRB104 21496 KTG 36788 b
1

(c) All PACE organizations selected shall begin operations
2
no later than June 30, 2024.
3

(d) Using a risk-based financing model, the organizations
4
contracted to implement the PACE program shall assume
5
responsibility for all costs generated by the PACE program
6
participants, and shall create and maintain a risk reserve
7
fund that will cover any cost overages for any participant.
8
The PACE program is responsible for the entire range of
9
services in the consolidated service model, including hospital
10
and nursing home care, according to participant need as
11
determined by a multidisciplinary team. The contracted
12
organizations are responsible for the full financial risk.
13
Specific arrangements of the risk-based financing model shall
14
be adopted and negotiated by the federal Centers for Medicare
15
and Medicaid Services, the organizations contracted to
16
implement the PACE program, and the Department of Healthcare
17
and Family Services.
18

(e) The requirements of the PACE model, as provided for
19
under Section 1894 (42 U.S.C. Sec. 1395eee) and Section 1934
20
(42 U.S.C. Sec. 1396u-4) of the federal Social Security Act,
21
shall not be waived or modified. The requirements that shall
22
not be waived or modified include all of the following:
23

(1) The focus on frail elderly qualifying individuals
24

who require the level of care provided in a nursing
25

facility.
26

(2) The delivery of comprehensive, integrated acute

SB4192
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LRB104 21496 KTG 36788 b
1

and long-term care services.
2

(3) The interdisciplinary team approach to care
3

management and service delivery.
4

(4) Capitated, integrated financing that allows the
5

provider to pool payments received from public and private
6

programs and individuals.
7

(5) The assumption by the provider of full financial
8

risk.
9

(6) The provision of a PACE benefit package for all
10

participants, regardless of source of payment, that shall
11

include all of the following:
12

(A) All Medicare-covered items and services.
13

(B) All Medicaid-covered items and services, as
14

specified in the Illinois Title XIX State Plan.
15

(C) Other services determined necessary by the
16

interdisciplinary team to improve and maintain the
17

participant's overall health status.
18

(f) The provisions under Sections 1-7 and 5-4 of the
19
Illinois Public Aid Code and under 80 Ill. Adm. Code 120.379,
20
120.380, and 120.385 shall apply when determining the
21
eligibility for medical assistance of a person receiving PACE
22
services from an organization providing services under this
23
Act.
24

(g) Provisions governing the treatment of income and
25
resources of a married couple, for the purposes of determining
26
the eligibility of a nursing-facility certifiable or

SB4192
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LRB104 21496 KTG 36788 b
1
institutionalized spouse, shall be established so as to
2
qualify for federal financial participation.
3

(h) Notwithstanding subsection (e), and only to the extent
4
federal financial participation is available, the Department
5
of Healthcare and Family Services, in consultation with PACE
6
organizations, may seek increased federal regulatory
7
flexibility from the federal Centers for Medicare and Medicaid
8
Services to modernize the PACE program, which may include, but
9
is not limited to, addressing all of the following:
10

(A) Composition of PACE interdisciplinary teams.
11

(B) Use of community-based physicians.
12

(C) Marketing practices.
13

(D) Development of a streamlined PACE waiver process.
14

This subsection shall be operative upon federal approval
15
of a capitation rate methodology as provided under Section 16.
16

(i) Each PACE organization shall provide the Department
17
with required reporting documents as set forth in 42 CFR
18
460.190 through 42 CFR 460.196.
19

(j) The geographic area consisting of the following zip
20
codes in Cook County shall be a designated service area under
21
the PACE program: 60610, 60613,60614, 60640, and 60657.

22
(Source: P.A. 102-43, eff. 7-6-21.)

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