Title 42, Part 460 — Programs of All-inclusive Care for the Elderly (Pace)
91 sections
Section 460.2
Basis.
Section 460.3
Part D program requirements.
Section 460.4
Scope and purpose.
Section 460.6
Definitions.
Section 460.10
Purpose.
Section 460.12
Application requirements.
Section 460.14
[Reserved]
Section 460.16
[Reserved]
Section 460.18
CMS evaluation of applications.
Section 460.19
Issuance of compliance actions for failure to comply with the terms of the PACE program agreement.
Section 460.20
Notice of CMS determination.
Section 460.24
Limit on number of PACE program agreements.
Section 460.26
Submission and evaluation of waiver requests.
Section 460.28
Notice of CMS determination on waiver requests.
Section 460.30
Program agreement requirement.
Section 460.32
Content and terms of PACE program agreement.
Section 460.34
Duration of PACE program agreement.
Section 460.40
Violations for which CMS may impose sanctions.
Section 460.42
Suspension of enrollment or payment by CMS.
Section 460.46
Civil money penalties.
Section 460.48
Additional actions by CMS or the State.
Section 460.50
Termination of PACE program agreement.
Section 460.52
Transitional care during termination.
Section 460.54
Termination procedures.
Section 460.56
Procedures for imposing sanctions and civil money penalties.
Section 460.60
PACE organizational structure.
Section 460.62
Governing body.
Section 460.63
Compliance oversight requirements.
Section 460.64
Personnel qualifications for staff with direct participant contact.
Section 460.66
Training.
Section 460.68
Program integrity.
Section 460.70
Contracted services.
Section 460.71
Oversight of direct participant care.
Section 460.72
Physical environment.
Section 460.74
Infection control.
Section 460.76
Transportation services.
Section 460.78
Dietary services.
Section 460.80
Fiscal soundness.
Section 460.82
Marketing.
Section 460.84
Emergency preparedness.
Section 460.86
Payment to individuals and entities excluded by the OIG or included on the preclusion list.
Section 460.90
PACE benefits under Medicare and Medicaid.
Section 460.92
Required services.
Section 460.94
Required services for Medicare participants.
Section 460.96
Excluded services.
Section 460.98
Service delivery.
Section 460.100
Emergency care.
Section 460.102
Interdisciplinary team.
Section 460.104
Participant assessment.
Section 460.106
Plan of care.
Section 460.110
Bill of rights.
Section 460.112
Specific rights to which a participant is entitled.
Section 460.114
Restraints.
Section 460.116
Explanation of rights.
Section 460.118
Violation of rights.
Section 460.119
Resolution of complaints in the complaints tracking module.
Section 460.120
Grievance process.
Section 460.121
Service determination process.
Section 460.122
PACE organization's appeals process.
Section 460.124
Additional appeal rights under Medicare or Medicaid.
Section 460.130
General rule.
Section 460.132
Quality improvement plan.
Section 460.134
Minimum requirements for quality improvement program.
Section 460.136
Internal quality improvement activities.
Section 460.138
Committees with community input.
Section 460.150
Eligibility to enroll in a PACE program.
Section 460.152
Enrollment process.
Section 460.154
Enrollment agreement.
Section 460.156
Other enrollment procedures.
Section 460.158
Effective date of enrollment.
Section 460.160
Continuation of enrollment.
Section 460.162
Voluntary disenrollment.
Section 460.164
Involuntary disenrollment.
Section 460.166
Disenrollment responsibilities.
Section 460.168
Reinstatement in other Medicare and Medicaid programs.
Section 460.170
Reinstatement in PACE.
Section 460.172
Documentation of disenrollment.
Section 460.180
Medicare payment to PACE organizations.
Section 460.182
Medicaid payment.
Section 460.184
Post-eligibility treatment of income.
Section 460.186
PACE premiums.
Section 460.190
Monitoring during trial period.
Section 460.192
Ongoing monitoring after trial period.
Section 460.194
Corrective action.
Section 460.196
Disclosure of review results.
Section 460.198
Disclosure of compliance deficiencies.
Section 460.200
Maintenance of records and reporting of data.
Section 460.202
Participant health outcomes data.
Section 460.204
Financial recordkeeping and reporting requirements.
Section 460.208
Financial statements.
Section 460.210
Medical records.