[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: 42CFR460.6]



[Page 427-428]

 

                         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 A_Basis, Scope, and Definitions

 

Sec.  460.6  Definitions.



    As used in this part, unless the context indicates otherwise, the 

following definitions apply:

    Contract year means the term of a PACE program agreement, which is a 

calendar year, except that a PACE organization's initial contract year 

may be from 12 to 23 months, as determined by CMS.

    Medicare beneficiary means an individual who is entitled to Medicare 

Part A benefits or enrolled under Medicare Part B, or both.

    Medicaid participant means an individual determined eligible for 

Medicaid who is enrolled in a PACE program.

    Medicare participant means a Medicare beneficiary who is enrolled in 

a PACE program.

    PACE stands for programs of all-inclusive care for the elderly.

    PACE center means a facility operated by a PACE organization where 

primary care is furnished to participants.

    PACE organization means an entity that has in effect a PACE program 

agreement to operate a PACE program under this part.

    PACE program agreement means an agreement between a PACE 

organization, CMS, and the State administering agency for the operation 

of a PACE program.

    Participant means an individual who is enrolled in a PACE program.



[[Page 428]]



    Services includes both items and services.

    State administering agency means the State agency responsible for 

administering the PACE program agreement.

    Trial period means the first 3 contract years in which a PACE 

organization operates under a PACE program agreement, including any 

contract year during which the entity operated under a PACE 

demonstration waiver program.