[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: 42CFR460.68]



[Page 435]

 

                         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 E_PACE Administrative Requirements

 

Sec.  460.68  Program integrity.



    (a) Persons with criminal convictions. A PACE organization must not 

employ individuals or contract with organizations or individuals--

    (1) Who have been excluded from participation in the Medicare or 

Medicaid programs;

    (2) Who have been convicted of criminal offenses related to their 

involvement in Medicaid, Medicare, other health insurance or health care 

programs, or social service programs under title XX of the Act; or

    (3) In any capacity where an individual's contact with participants 

would pose a potential risk because the individual has been convicted of 

physical, sexual, drug, or alcohol abuse.

    (b) Direct or indirect interest in contracts. No member of the PACE 

organization's governing body or any immediate family member may have a 

direct or indirect interest in any contract that supplies any 

administrative or care-related service or materials to the PACE 

organization.

    (c) [Reserved]

    (d) Disclosure requirements. A PACE organization must have a formal 

process in place to gather information related to paragraphs (a) and (b) 

of this section and must be able to respond in writing to a request for 

information from CMS within a reasonable amount of time.



[64 FR 66279, Nov. 24, 1999, as amended at 67 FR 61505, Oct. 1, 2002]