[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

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

[CITE: 42CFR460.50]



[Page 432]

 

                         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 

 

        Subpart D_Sanctions, Enforcement Actions, and Termination

 

Sec.  460.50  Termination of PACE program agreement.



    (a) Termination of agreement by CMS or State. CMS or a State 

administering agency may terminate at any time a PACE program agreement 

for cause, including, but not limited to the circumstances in paragraphs 

(b) or (c) of this section.

    (b) Termination due to uncorrected deficiencies. CMS or the State 

administering agency may terminate a PACE program agreement if CMS or 

the State administering agency determines that both of the following 

circumstances exist:

    (1) Either--

    (i) There are significant deficiencies in the quality of care 

furnished to participants; or

    (ii) The PACE organization failed to comply substantially with 

conditions for a PACE program or PACE organization under this part, or 

with terms of its PACE program agreement.

    (2) Within 30 days of the date of the receipt of written notice of a 

determination made under paragraph (b)(1) of this section, the PACE 

organization failed to develop and successfully initiate a plan to 

correct the deficiencies, or failed to continue implementation of the 

plan of correction.

    (c) Termination due to health and safety risk. CMS or a State 

administering agency may terminate a PACE program agreement if CMS or 

the State administering agency determines that the PACE organization 

cannot ensure the health and safety of its participants. This 

determination may result from the identification of deficiencies that 

CMS or the State administering agency determines cannot be corrected.

    (d) Termination of agreement by PACE organization. A PACE 

organization may terminate an agreement after timely notice to CMS, the 

State administering agency, and participants, as follows:

    (1) To CMS and the State administering agency, 90 days before 

termination.

    (2) To participants, 60 days before termination.