StacksVerified U.S. regulatory reference

42 CFR §460.42

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov
  1. (a)Enrollment. If a PACE organization commits one or more violations specified in § 460.40, CMS may suspend enrollment of Medicare beneficiaries after the date CMS notifies the organization of the violation.
  2. (b)Payment. If a PACE organization commits one or more violations specified in § 460.40, for individuals enrolled after the date CMS notifies the PACE organization of the violation, CMS may take the following actions:
    1. (1)Suspend Medicare payment to the PACE organization.
    2. (2)Deny payment to the State for medical assistance for services furnished under the PACE program agreement.
  3. (c)Term of suspension. A suspension or denial of payment remains in effect until CMS is satisfied that the following conditions are met:
    1. (1)The PACE organization has corrected the cause of the violation.
    2. (2)The violation is not likely to recur.