Current through Register Vol. 42, No. 10, July 31, 2024
Section 560-X-53-.02 - DefinitionsAs 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.Ala. Admin. Code r. 560-X-53-.02
Emergency rule effective May 1, 1991. Permanent rule effective August 14, 1991. Repealed: Filed April 5, 1999; effective May 10, 1999. New Rule: Filed November 10, 2011; effective December 15, 2011.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.