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FEDERAL · 42 CFR

Part 460 — Programs of All-Inclusive Care for the Elderly (PACE)

91 sections · Title 42: Public Health

§ 460.2Basis.
§ 460.3Part D program requirements.
§ 460.4Scope and purpose.
§ 460.6Definitions.
§ 460.10Purpose.
§ 460.12Application requirements.
§ 460.14§ 460.14 [Reserved]
§ 460.16§ 460.16 [Reserved]
§ 460.18CMS evaluation of applications.
§ 460.19Issuance of compliance actions for failure to comply with the terms of the PACE program agreement.
§ 460.20Notice of CMS determination.
§ 460.24Limit on number of PACE program agreements.
§ 460.26Submission and evaluation of waiver requests.
§ 460.28Notice of CMS determination on waiver requests.
§ 460.30Program agreement requirement.
§ 460.32Content and terms of PACE program agreement.
§ 460.34Duration of PACE program agreement.
§ 460.40Violations for which CMS may impose sanctions.
§ 460.42Suspension of enrollment or payment by CMS.
§ 460.46Civil money penalties.
§ 460.48Additional actions by CMS or the State.
§ 460.50Termination of PACE program agreement.
§ 460.52Transitional care during termination.
§ 460.54Termination procedures.
§ 460.56Procedures for imposing sanctions and civil money penalties.
§ 460.60PACE organizational structure.
§ 460.62Governing body.
§ 460.63Compliance oversight requirements.
§ 460.64Personnel qualifications for staff with direct participant contact.
§ 460.66Training.
§ 460.68Program integrity.
§ 460.70Contracted services.
§ 460.71Oversight of direct participant care.
§ 460.72Physical environment.
§ 460.74Infection control.
§ 460.76Transportation services.
§ 460.78Dietary services.
§ 460.80Fiscal soundness.
§ 460.82Marketing.
§ 460.84Emergency preparedness.
§ 460.86Payment to individuals and entities excluded by the OIG or included on the preclusion list.
§ 460.90PACE benefits under Medicare and Medicaid.
§ 460.92Required services.
§ 460.94Required services for Medicare participants.
§ 460.96Excluded services.
§ 460.98Service delivery.
§ 460.100Emergency care.
§ 460.102Interdisciplinary team.
§ 460.104Participant assessment.
§ 460.106Plan of care.
§ 460.110Bill of rights.
§ 460.112Specific rights to which a participant is entitled.
§ 460.114Restraints.
§ 460.116Explanation of rights.
§ 460.118Violation of rights.
§ 460.119Resolution of complaints in the complaints tracking module.
§ 460.120Grievance process.
§ 460.121Service determination process.
§ 460.122PACE organization's appeals process.
§ 460.124Additional appeal rights under Medicare or Medicaid.
§ 460.130General rule.
§ 460.132Quality improvement plan.
§ 460.134Minimum requirements for quality improvement program.
§ 460.136Internal quality improvement activities.
§ 460.138Committees with community input.
§ 460.150Eligibility to enroll in a PACE program.
§ 460.152Enrollment process.
§ 460.154Enrollment agreement.
§ 460.156Other enrollment procedures.
§ 460.158Effective date of enrollment.
§ 460.160Continuation of enrollment.
§ 460.162Voluntary disenrollment.
§ 460.164Involuntary disenrollment.
§ 460.166Disenrollment responsibilities.
§ 460.168Reinstatement in other Medicare and Medicaid programs.
§ 460.170Reinstatement in PACE.
§ 460.172Documentation of disenrollment.
§ 460.180Medicare payment to PACE organizations.
§ 460.182Medicaid payment.
§ 460.184Post-eligibility treatment of income.
§ 460.186PACE premiums.
§ 460.190Monitoring during trial period.
§ 460.192Ongoing monitoring after trial period.
§ 460.194Corrective action.
§ 460.196Disclosure of review results.
§ 460.198Disclosure of compliance deficiencies.
§ 460.200Maintenance of records and reporting of data.
§ 460.202Participant health outcomes data.
§ 460.204Financial recordkeeping and reporting requirements.
§ 460.208Financial statements.
§ 460.210Medical records.