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