Program of All Inclusive Care for the Elderly (PACE)

The Nevada Health Authority is requesting proposals for Program of All Inclusive Care for the Elderly (PACE) operations across Nevada under RFP 41NHA-S4038, with proposals due December 10, 2026 at 2:00 p.m. PST and questions due October 22, 2026. The State intends to award multiple contracts but is under no obligation to award any; awarded contractors must obtain Centers for Medicare and Medicaid Services (CMS) approval, with service commencement targeted for State Fiscal Year 2028-2029 contingent on successful Readiness Review.

Vendors may propose to operate one or more PACE sites within defined service areas: Clark County, Washoe County, or All Rural Counties. The program serves eligible seniors ages 55 and older who meet Medicaid eligibility and nursing facility level of care requirements. Contractors must establish a Governing Body of at least seven members, a Participant Advisory Committee with annual meetings, and designate a Program Director residing in Nevada. Each PACE Center is authorized to serve up to 300 participants.

Services include multidisciplinary assessment and treatment planning, physician services, adult day health care, social work, physical/occupational/speech-language pathology therapies, hospital and nursing facility services, assisted living, home care, nutritional counseling, transportation, behavioral health and substance abuse services, dental, pharmacy, podiatry, laboratory and diagnostic procedures, prosthetics and durable medical equipment, vision services, and audiology services. Contractors may deliver services directly or through subcontract.

Pricing is fixed monthly capitation at 94 percent of actuarially developed rates, varying by service area and eligibility status: Clark County ($4,978.04 for Full Dual Eligibles and $8,385.06 for Non-Dual eligible individuals), Washoe County ($4,532.24 for Full Dual Eligibles and $7,642.05 for Non-Dual eligible individuals), and All Rural Counties ($5,226.94 for Full Dual Eligibles and $8,804.32 for Non-Dual eligible individuals). All administrative, operational, and service costs are included; no cost proposals are required.

The contract term runs through December 31, 2032, with an option to extend up to four additional years. Contractors must demonstrate financial stability through a $1.5 million performance security deposit in surety bond form due within 15 calendar days following the end of the first quarter of contract term.

Evaluation criteria: Technical Proposal Response to Questions (100 points, structured across Overall Experience, Operational Plan, Financial Capacity, Quality Assessment and Improvement Plan, and optional rural investment bonus scoring; maximum 70 pages) and Financial Stability (pass/fail). References must be submitted by December 9, 2026. Anticipated award is April 30, 2027; Board of Examiners approval estimated June 8, 2027.

Mandatory minimum requirements include Nevada business license, active sam.gov entity registration, nevadaepro.com registration, compliance with Nevada law regarding indemnity and Israel boycott prohibition, data encryption and U.S.-based data maintenance, and certifications regarding non-discrimination, drug-free workplace policies, and independent pricing decisions. Contractors must comply with federal 42 CFR 460 regulations, HIPAA and Business Associate Addendum requirements, NIST SP 800-53 security standards, GovRAMP requirements (effective July 1, 2026), comprehensive Business Continuity and Disaster Recovery Plans, licensing through Nevada's Bureau of Health Care Quality and Compliance, and Nevada Medicaid enrollment. Penalty provisions range from $5,000 to $30,000 per occurrence for non-compliance. Late invoice submissions incur an administrative fee not to exceed $100.