42 C.F.R. § 460.26 Submission and evaluation of waiver requests.
Title 42 - Public Health
(a) A PACE organization must submit its waiver request through the State administering agency for initial review. The State administering agency forwards waiver requests to CMS along with any concerns or conditions regarding the waiver. (b) CMS evaluates a waiver request from a PACE organization on the basis of the following information: (1) The adequacy of the description and rationale for the waiver provided by the PACE organization, including any additional information requested by CMS. (2) Information obtained by CMS and the State administering agency in on-site reviews and monitoring of the PACE organization. (c) Requirements related to the following principles may not be waived: (1) A focus on frail elderly qualifying individuals who require the level of care provided in a nursing facility. (2) The delivery of comprehensive, integrated acute and long-term care services. (3) An interdisciplinary team approach to care management and service delivery. (4) Capitated, integrated financing that allows the provider to pool payments received from public and private programs and individuals. (5) The assumption by the provider of full financial risk. [67 FR 61505, Oct. 1, 2002; 67 FR 63966, Oct. 16, 2002]
Title 42: Public Health
PART 460—PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
Subpart B—PACE Organization Application and Waiver Process
§ 460.26 Submission and evaluation of waiver requests.
