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42 U.S.C. 1302, 1395, 1395eee(f), and 1396u-4(f).
64 FR 66279, Nov. 24, 1999, unless otherwise noted.
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Nomenclature changes to part 460 appear at 67 FR 61504, Oct. 1, 2002.
(a) The PACE benefit package for all participants, regardless of the source of payment, must include the following:
(1) All Medicare-covered services.
(2) All Medicaid-covered services, as specified in the State's approved Medicaid plan.
(3) Other services determined necessary by the interdisciplinary team to improve and maintain the participant's overall health status.
(b) Decisions by the interdisciplinary team to provide or deny services under paragraph (a) of this section must be based on an evaluation of the participant that takes into account:
(1) The participant's current medical, physical, emotional, and social needs; and
(2) Current clinical practice guidelines and professional standards of care applicable to the particular service.
[86 FR 6132, Jan. 19, 2021]