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-.17 - Sanctions And Enforcement Actions
Current through Register Vol. 43, No. 02, November 27, 2024
(1) Penalties and sanctions may be imposed by CMS for a PO if it is determined that the PO has committed any of the violations listed n §460.40. Penalties and/or sanction will be imposed in addition to any other remedies authorized by law.
(2) CMS may also elect to suspend the enrollment of Medicare beneficiaries. CMS may also suspend Medicare payments to the PO or deny payment to AMA for medical assistance for services provided under the PACE agreement. Limitations for civil monetary penalties are addressed in §460.46. The penalties and sanctions imposed will be effective until CMS determines the cause of the violation has been corrected or the violation will not likely recur.
(3) As specified in §460.48, if CMS or AMA determine that a PO is not in compliance, one or more of the following actions will be taken:
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 Subpart D.