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Code of Federal Regulations (Last Updated: July 5, 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) |
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Subpart F - PACE Services |
§ 460.92 - Required services.
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§ 460.92 Required services.
b(a) The PACE benefit package for all participants, regardless of the source of payment, must include the following:
a(
items and1) All Medicare-covered
services.
(
items and2) All Medicaid-covered
cservices, as specified in the State's approved Medicaid plan.
(
[71 FR 71335, Dec. 8, 20063) Other services determined necessary by the interdisciplinary team to improve and maintain the participant's overall health status.
(b) Decisions by the interdisciplinary team to provide or deny services under paragraph (a) of this section must be based on an evaluation of the participant that takes into account:
(1) The participant's current medical, physical, emotional, and social needs; and
(2) Current clinical practice guidelines and professional standards of care applicable to the particular service.
[86 FR 6132, Jan. 19, 2021]