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Code of Federal Regulations (Last Updated: November 8, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter E - Programs of All-Inclusive Care for the Elderly (Pace) |
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Part 460 - Programs of All-Inclusive Care for the Elderly (Pace) |
| Subpart A - Basis, Scope, and Definitions |
| § 460.2 - Basis. |
| § 460.3 - xxx |
| § 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 - [Reserved] |
| § 460.16 - [Reserved] |
| § 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. |
| § 460.22 - 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. |
| § 460.56 - xxx |
| Subpart E - PACE Administrative Requirements |
| § 460.60 - PACE organizational structure. |
| § 460.62 - Governing body. |
| § 460.63 - xxx |
| § 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 |
| § 460.130 - General rule. |
| § 460.132 - Quality improvement plan. |
| § 460.134 - Minimum requirements for quality improvement program. |
| § 460.136 - Internal quality 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 - Disenrollment responsibilities. |
| § 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. |
| § 460.198 - Disclosure of compliance deficiencies. |
| 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. |