e-CFR data is current as of August 13, 2020
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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