[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR460.94]



[Page 428-429]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 460_PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)--Table 

of Contents

 

                         Subpart F_PACE Services

 

Sec. 460.94  Required services for Medicare participants.



    (a) Except for Medicare requirements that are waived for the PACE 

program, as specified in paragraph (b) of this section, the PACE benefit 

package for Medicare participants must include the following services:

    (1) The scope of hospital insurance benefits described in part 409 

of this chapter.



[[Page 429]]



    (2) The scope of supplemental medical insurance benefits described 

in part 410 of this chapter.

    (b) Waivers of Medicare coverage requirements. The following 

Medicare requirements are waived for purposes of the PACE program and do 

not apply:

    (1) The provisions of subpart F of part 409 of this chapter that 

limit coverage of institutional services.

    (2) The provisions of subparts G and H of part 409 of this chapter, 

and parts 412 through 414 of this chapter that relate to payment for 

benefits.

    (3) The provisions of subparts D and E of part 409 of this chapter 

that limit coverage of extended care services or home health services.

    (4) The provisions of subpart D of part 409 of this chapter that 

impose a 3-day prior hospitalization requirement for coverage of 

extended care services.

    (5) Sections 411.15(g) and (k) of this chapter that may prevent 

payment for PACE program services to PACE participants.