e-CFR data is current as of March 3, 2021
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
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Part D program requirements. |
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Subpart B—PACE ORGANIZATION APPLICATION AND WAIVER PROCESS
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Application requirements. |
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CMS evaluation of applications. |
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Notice of CMS determination. |
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Limit on number of PACE program agreements. |
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Submission and evaluation of waiver requests. |
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Notice of CMS determination on waiver requests. |
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Subpart C—PACE PROGRAM AGREEMENT
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Program agreement requirement. |
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Content and terms of PACE program agreement. |
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Duration of PACE program agreement. |
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Subpart D—SANCTIONS, ENFORCEMENT ACTIONS, AND TERMINATION
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Violations for which CMS may impose sanctions. |
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Suspension of enrollment or payment by CMS. |
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Additional actions by CMS or the State. |
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Termination of PACE program agreement. |
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Transitional care during termination. |
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Subpart E—PACE ADMINISTRATIVE REQUIREMENTS
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PACE organizational structure. |
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Compliance oversight requirements. |
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Personnel qualifications for staff with direct participant contact. |
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Oversight of direct participant care. |
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Payment to individuals and entities excluded by the OIG or included on the preclusion list. |
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Subpart F—PACE SERVICES
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PACE benefits under Medicare and Medicaid. |
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Required services for Medicare participants. |
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Subpart G—PARTICIPANT RIGHTS
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Specific rights to which a participant is entitled. |
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PACE organization's appeals process. |
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Additional appeal rights under Medicare or Medicaid. |
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Subpart H—QUALITY IMPROVEMENT
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Quality improvement plan. |
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Minimum requirements for quality improvement program. |
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Internal quality improvement activities. |
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Committees with community input. |
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Subpart I—PARTICIPANT ENROLLMENT AND DISENROLLMENT
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Eligibility to enroll in a PACE program. |
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Other enrollment procedures. |
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Effective date of enrollment. |
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Continuation of enrollment. |
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Involuntary disenrollment. |
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Disenrollment responsibilities. |
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Reinstatement in other Medicare and Medicaid programs. |
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Documentation of disenrollment. |
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Subpart J—PAYMENT
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Medicare payment to PACE organizations. |
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Post-eligibility treatment of income. |
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Subpart K—FEDERAL/STATE MONITORING
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Monitoring during trial period. |
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Ongoing monitoring after trial period. |
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Disclosure of review results. |
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Subpart L—DATA COLLECTION, RECORD MAINTENANCE, AND REPORTING
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Maintenance of records and reporting of data. |
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Participant health outcomes data. |
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Financial recordkeeping and reporting requirements. |
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