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e-CFR Data is current as of February 4, 2010
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
Subpart B--PACE ORGANIZATION APPLICATION AND WAIVER PROCESS
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| Application requirements. |
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| CMS evaluation of applications. |
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| Notice of CMS determination. |
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| Service area designation. |
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| Limit on number of PACE program agreements. |
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| Submission and evaluation of waiver requests. |
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| Notice of CMS determination on waiver requests. |
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Subpart C--PACE PROGRAM AGREEMENT
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| Program agreement requirement. |
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| Content and terms of PACE program agreement. |
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| Duration of PACE program agreement. |
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Subpart D--SANCTIONS, ENFORCEMENT ACTIONS, AND TERMINATION
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| Violations for which CMS may impose sanctions. |
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| Suspension of enrollment or payment by CMS. |
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| Additional actions by CMS or the State. |
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| Termination of PACE program agreement. |
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| Transitional care during termination. |
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Subpart E--PACE ADMINISTRATIVE REQUIREMENTS
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| PACE organizational structure. |
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| Personnel qualifications for staff with direct participant contact. |
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| Oversight of direct participant care. |
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Subpart F--PACE SERVICES
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| PACE benefits under Medicare and Medicaid. |
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| Required services for Medicare participants. |
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Subpart G--PARTICIPANT RIGHTS
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| Specific rights to which a participant is entitled. |
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| PACE organization's appeals process. |
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| Additional appeal rights under Medicare or Medicaid. |
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Subpart H--QUALITY ASSESSMENT AND PERFORMANCE IMPROVEMENT
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| Quality assessment and performance improvement plan. |
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| Minimum requirements for quality assessment and performance improvement program. |
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| Internal quality assessment and performance improvement activities. |
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| Committees with community input. |
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| Additional quality assessment activities. |
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Subpart I--PARTICIPANT ENROLLMENT AND DISENROLLMENT
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| Eligibility to enroll in a PACE program. |
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| Other enrollment procedures. |
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| Effective date of enrollment. |
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| Continuation of enrollment. |
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| Involuntary disenrollment. |
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| Effective date of disenrollment. |
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| Reinstatement in other Medicare and Medicaid programs. |
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| Documentation of disenrollment. |
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Subpart J--PAYMENT
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| Medicare payment to PACE organizations. |
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| Post-eligibility treatment of income. |
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Subpart K--FEDERAL/STATE MONITORING
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| Monitoring during trial period. |
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| Ongoing monitoring after trial period. |
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| Disclosure of review results. |
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Subpart L--DATA COLLECTION, RECORD MAINTENANCE, AND REPORTING
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| Maintenance of records and reporting of data. |
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| Participant health outcomes data. |
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| Financial recordkeeping and reporting requirements. |
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