e-CFR data is current as of December 4, 2019
TITLE 42—Public Health
CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) SUBCHAPTER E—PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PART 460—PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
Subpart A—BASIS, SCOPE, AND DEFINITIONS
|
| Part D program requirements. |
|
Subpart B—PACE ORGANIZATION APPLICATION AND WAIVER PROCESS
|
| Application requirements. |
|
|
| CMS evaluation of applications. |
|
|
| Notice of CMS determination. |
|
|
| Limit on number of PACE program agreements. |
|
|
| Submission and evaluation of waiver requests. |
|
|
| Notice of CMS determination on waiver requests. |
|
Subpart C—PACE PROGRAM AGREEMENT
|
| Program agreement requirement. |
|
|
| Content and terms of PACE program agreement. |
|
|
| Duration of PACE program agreement. |
|
Subpart D—SANCTIONS, ENFORCEMENT ACTIONS, AND TERMINATION
|
| Violations for which CMS may impose sanctions. |
|
|
| Suspension of enrollment or payment by CMS. |
|
|
| Additional actions by CMS or the State. |
|
|
| Termination of PACE program agreement. |
|
|
| Transitional care during termination. |
|
Subpart E—PACE ADMINISTRATIVE REQUIREMENTS
|
| PACE organizational structure. |
|
|
| Compliance oversight requirements. |
|
|
| Personnel qualifications for staff with direct participant contact. |
|
|
| Oversight of direct participant care. |
|
|
| Payment to individuals and entities excluded by the OIG or included on the preclusion list. |
|
Subpart F—PACE SERVICES
|
| PACE benefits under Medicare and Medicaid. |
|
|
| Required services for Medicare participants. |
|
Subpart G—PARTICIPANT RIGHTS
|
| Specific rights to which a participant is entitled. |
|
|
| PACE organization's appeals process. |
|
|
| Additional appeal rights under Medicare or Medicaid. |
|
Subpart H—QUALITY IMPROVEMENT
|
| Quality improvement plan. |
|
|
| Minimum requirements for quality improvement program. |
|
|
| Internal quality improvement activities. |
|
|
| Committees with community input. |
|
Subpart I—PARTICIPANT ENROLLMENT AND DISENROLLMENT
|
| Eligibility to enroll in a PACE program. |
|
|
| Other enrollment procedures. |
|
|
| Effective date of enrollment. |
|
|
| Continuation of enrollment. |
|
|
| Involuntary disenrollment. |
|
|
| Disenrollment responsibilities. |
|
|
| Reinstatement in other Medicare and Medicaid programs. |
|
|
| Documentation of disenrollment. |
|
Subpart J—PAYMENT
|
| Medicare payment to PACE organizations. |
|
|
| Post-eligibility treatment of income. |
|
Subpart K—FEDERAL/STATE MONITORING
|
| Monitoring during trial period. |
|
|
| Ongoing monitoring after trial period. |
|
|
| Disclosure of review results. |
|
Subpart L—DATA COLLECTION, RECORD MAINTENANCE, AND REPORTING
|
| Maintenance of records and reporting of data. |
|
|
| Participant health outcomes data. |
|
|
| Financial recordkeeping and reporting requirements. |
|
| 
