D.C. Mun. Regs. tit. 29, r. 29-8899

Current through Register 71, No. 45, November 7, 2024
Rule 29-8899 - DEFINITIONS

When used in this chapter, the following terms and phrases shall have the meanings ascribed:

Contract year - The term of a PACE program agreement, which is a calendar year, except that a PACE organization's initial contract year may be from twelve (12) to twenty-three (23) months, as determined by CMS.

PACE center - A facility operated by an approved PACE organization, which includes a primary care clinic, areas for therapeutic recreation, restorative therapies, socialization, personal care, and dining, and which serves as the focal point for coordination and provision of most PACE services.

PACE organization - An entity as defined in 42 CFR § 460.6 that has in effect a PACE program agreement to operate a PACE program in the District.

PACE program - A program of all-inclusive care for the elderly that is operated by an approved PACE organization and that provides comprehensive healthcare services to PACE enrollees in accordance with a PACE program agreement.

PACE program agreement - An agreement between a PACE organization, CMS, and DHCF for the operation of a PACE program.

Post-stabilization care - Non-emergency services provided subsequent to an emergency that a treating physician views as medically necessary after an emergency medical condition has been stabilized.

Program of All-Inclusive Care for the Elderly (PACE) - A jointly administered capitated Medicare/Medicaid program providing medical and long-term care services to individuals fifty-five (55) years of age and older who require a nursing home level of care.

Urgent care - The care provided to a PACE participant who is out of the PACE service area, and who believes their illness or injury is too severe to postpone treatment until they return to the service area, but their life or function is not in severe jeopardy.

D.C. Mun. Regs. tit. 29, r. 29-8899

Final Rulemaking published at 69 DCR 6400 (6/3/2022)