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42 C.F.R. PART 460--PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)

TITLE 42--Public Health

CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES

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

�460.2

Basis.

�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

Priority consideration.

�460.16

Special consideration.

�460.18

CMS evaluation of applications.

�460.20

Notice of CMS determination.

�460.22

Service area designation.

�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.

Subpart E--PACE ADMINISTRATIVE REQUIREMENTS

�460.60

PACE organizational structure.

�460.62

Governing body.

�460.64

Personnel qualifications.

�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.

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.

�460.120

Grievance process.

�460.122

PACE organization's appeals process.

�460.124

Additional appeal rights under Medicare or Medicaid.

Subpart H--QUALITY ASSESSMENT AND PERFORMANCE IMPROVEMENT

�460.130

General rule.

�460.132

Quality assessment and performance improvement plan.

�460.134

Minimum requirements for quality assessment and performance improvement program.

�460.136

Internal quality assessment and performance improvement activities.

�460.138

Committees with community input.

�460.140

Additional quality assessment activities.

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

Effective date of disenrollment.

�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.

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.