All providers must sign the appropriate participation agreement. Collection of this information is mandated by statute under sections 1894f and 1934f of the act and at 42 cfr part 460, subpart b, which addresses the po application and waiver process. Pace, a managed care program, enables elderly individuals who are certified to need. In addition, this chapter outlines pace organization responsibilities, payers, premiums, and medicare part d. Jul 25, 2016 each pace plan shall meet the requirements of 32. Pace part d application request for additional information.
The pace marketing guidelines pmg interpret and provide guidance on marketing requirements and related provisions of the programs of allinclusive care for the elderly pace rules chapter 42 of the code of federal regulations cfr, part 460 see appendix 1 for a list of related laws and regulations. On page 56488, in our discussion of reducing the burden of the medical loss ratio mlr reporting requirements, we made errors in our description of the tasks performed. Cms pace expansion application 1004 cfr part 460, cms expansion scenarios via cms website 102005, state contract, and pace plan letter 0603 key personnel changes 071506. Electronic code of federal regulations e cfr title 42.
The term collection of information is defined in 44 u. The authority citation for part 460 continues to read as follows. Quality improvement is term commonly used among pace. Programs of allinclusive care for the elderly pace cms. Subchapter e programs of allinclusive care for the elderly pace part 460 programs of allinclusive care for the elderly pace subpart e pace administrative requirements section 460. Overview of the pace application process debbie van hoven division of medicare advantage. Jan 01, 2001 approving the pace program and joining the state in signing an agreement with the pace program once it has been approved as a provider under 42 cfr part 460. Programs of allinclusive care for the elderly pace sections 1894, 1905a, and 1934 of the act and 42 cfr 460. Part 460 programs of allinclusive care for the elderly pace subpart e pace administrative requirements section. Inclusive care for the elderly pace organization must comply with all applicable federal, state, and local emergency preparedness requirements. Programs of allinclusive care for the elderly pace agency.
The pace organization must employ, or contract with in accordance with 42 cfr 460. Cms finalizes new regulations for program of allinclusive. Proposal to replace all references in 42 cfr part 460 to quality assessment and performance improvement in the pae regulation with quality improvement. Pace plans operate under both medicare and medicaid capitation. It is the intent of the department that the pace program is a truly integrated model for the.
The requirements for the programs of allinclusive care for the elderly pace under the medicare and medicaid programs final regulations cover many regulatory requirements for pace programs and create new compliance. These regulations, as currently written or amended in the future, are incorporated by reference as the rule base for operating the pace program in oklahoma. Apr 01, 2019 the information on this page is current as of april 1 2019. Regulatory authority for pace can be found in 42 cfr part 460. Subpart b pace organization application and waiver process 460. Finally, if an organization is contemplating a pace change of ownership chow, please be aware that the chow may require the submission of an application to ensure the acquiring organization meets the requirements under 42 cfr part 460 subpart b. Elderly pace conformance with pace legislation pursuant to section 1934 of the social security act and implementing regulations at 42 cfr 460. Quality improvement is term commonly used among pace organizations pos, state administering agencies.
The program for the allinclusive care for the elderly pace organization must comply with all applicable federal, state, and local emergency preparedness requirements. Programs of allinclusive care for the elderly requirements. Federal pace regulations are located at 42 cfr, part 460. The pace plan must conduct a criminal history background check on any proposed personal assistance caregiver. For purposes of this part and all contracts establishing the program of allinclusive care for the elderly pace programs as defined in 42 cfr part 460, the following definitions shall apply. The ifc revised pertinent msp regulations found at 42 cfr part 411. Subchapter e programs of allinclusive care for the elderly pace part 460 programs of allinclusive care for the elderly. The organization must ensure that the participant or caregiver, or both, understand when. In general, pace services are provided through a po.
This final rule will revise the medicare advantage ma program part c regulations and prescription drug benefit program part d regulations to implement certain. Programs of allinclusive care for the elderly pace subpart e. The basis for the regulations in this chapter is the commercial space launch act of. It is the intent of the department that the pace program is a. Part 460 encompasses the regulatory provisions pertaining to pace. Federal trade commission 16 cfr part 460 rin 3084ab40 labeling and advertising of home. Proposal to replace all references in 42 cfr part 460 to. Programs of allinclusive care for the elderly pace subpart f. Dec 31, 2015 pursuant to federal pace regulations found at 42 cfr part 460. Cms10631 the pace organization application process in 42 cfr part 460. Office of health insurance programs division of long term.
Department of health and human services centers for medicare. Programs of allinclusive care for the elderly pace chapter 6 services. For questions or further information on the pace expansion application requirements table, contact your. For the most uptodate version of cfr title 21, go to the electronic code of federal regulations ecfr. The program of allinclusive care for the elderly pace is an optional service under the. Statutory and regulatory citations for pace sections 1894, 1905a, and 1934 of the social security act and 42 cfr 460. Dotfaaar0436 title 14 code of federal regulations part. The pace model focuses on frail community dwelling elderly, most of whom are dually eligible for medicare and medicaid, and all of whom are assessed as being. The personal assistance caregiver will be subject to pace orientation, member specific plan of care competencies and ongoing supervision, conducted by the pace plan.
Proposal costs of past accounting periods will be allocable to the current period 200. The provisions in the ifc were finalized in a final rule published in the february 22, 2008 federal register. Pursuant to federal pace regulations at 42 cfr part 460. Summary of pace provider regulation, 42 cfr part 460 prepared by national pace association may 21, 2007 final regulation published in federal register, vol. Administrative code, chapter 53 and part 460 of the code of federal regulations. Draft program of allinclusive care for the elderly pace. If a pace is part of a healthcare system consisting of. Title 42 public health part 460 programs of allinclusive care for the elderly pace subchapter e programs of allinclusive care. As used in this rule, the following definitions apply. Subpart b pace organization application and waiver process. For questions or further information on the pace expansion application requirements table, contact your contract manager. Electronic code of federal regulations ecfr title 42.
Emergency preparedness regulations for programs of all. Summary of pace provider ergulations, 42cfr part 460. Programs of allinclusive care for the elderly pace part 460. Part 460 programs of allinclusive care for the elderly pace subpart abasis, scope, and definitions. Part 460 the pace organization prohibits or restricts a covered healthcare. A pace organization planning a change of ownership must comply with all requirements in 42 cfr part 422, subpart l, and must notify cms and the state administering agency, in writing, at least 60 days before the anticipated effective date of the change. On page 56366, in the listing of parts of the code of federal regulations cfr that are being revised by the proposed rule, we inadvertently omitted 42 cfr part 460. That rule governs foreign and domestic air agencies that perform maintenance and alterations on u. All pace providers must meet the general requirements and conditions for participation pursuant to the required contracts by dmas and cms.