Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-53 - PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
Section 560-X-53-.02 - Definitions

Universal Citation: AL Admin Code R 560-X-53-.02

Current through Register Vol. 43, No. 02, November 27, 2024

As used in this Rule, the following definitions apply:

(1) PACE - Programs of All-inclusive Care for the Elderly.

(2) PACE Organization (PO) - entity that has an agreement with Medicaid and CMS to operate a PACE program.

(3) PACE Center - facility operated by a PO where primary care is furnished to participants.

(4) State Administering Agency (SAA) - state agency responsible for administering the PACE Program Agreement.

(5) PACE Program Agreement - agreement between the State Administering Agency, CMS and PO for the operation of a PACE program.

(6) Participant - individual who is enrolled in a PACE program.

(7) Medicaid Participant - individual determined eligible for Medicaid who is enrolled in a PACE program.

(8) Medicare Beneficiary - individual who is entitled to Medicare Part A benefits, or is enrolled under Medicare Part B, or both.

(9) Medicare Participant - Medicare beneficiary who is enrolled in a PACE program.

(10) Services - includes items and services.

(11) Contract Year - the term of a PACE program agreement, which is a calendar year, except that the initial contract year may be from 12 to 23 months, as determined by CMS.

(12) Trial Period - the first three contract years in which a PO operates under a PACE program agreement, including any contract year during which the entity operated under a PACE demonstration period.

(13) AMA - Alabama Medicaid Agency.

(14) CMS - Center for Medicare and Medicaid Services.

Author: Linda Lackey, Medicaid Administrator, LTC Project Development Unit.

Statutory Authority: State Plan, Attachment 2.2-A, Attachment 3.1-A and Supplement 3; 4 2 CFR 460.6.

Disclaimer: These regulations may not be the most recent version. Alabama may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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