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
- § 460.10— Purpose.
- § 460.12— Application requirements.
- § 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
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
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.