173-50-01 Introduction and definitions.

 

 

 

173-50-01                    PACE: Introduction and definitions.

 

 

 

(A)  Introduction: Chapter 173-50 of the Administrative Code regulates PACE. PACE is a managed-care program that provides its participants with all of their necessary health care, medical care, and ancillary services in acute, sub-acute, institutional, and community settings. Examples of PACE services are primary and specialty care, adult day services, personal care services, inpatient hospital stays, prescription drugs, occupational therapy, physical therapy, and nursing facility care.

 

(B)Definitions for this chapter:

 

(1)"Authorized representative" has the same meaning as in rule 5160-36-01 of the Administrative Code.

 

(2) "CDJFS" means the "county department of job and family services."

 

(3) "CMS" means "the centers for medicare and medicaid services."

 

(4) "ODA" means "the Ohio department of aging."

 

(5) "ODM" means "the Ohio department of medicaid."

 

(6)"PACE" means "the program of all-inclusive care for the elderly," which is established by 42 C.F.R. 460 (October 1, 2013 edition).

 

(7)"PACE organization" means an entity that provides services to participants under a PACE program agreement with CMS and ODA.

 

(8) "Participant" means a person who receives services through PACE.

 

(B) Definitions for this chapter:

 

"Authorized representative" has the same meaning as in rule 5160-36-01 of the Administrative Code.

 

"CDJFS" means the "county department of job and family services."

 

"CMS" means "the centers for medicare and medicaid services."

 

"ODA" means "the Ohio department of aging."

 

"ODM" means "the Ohio department of medicaid."

 

"ODM's administrative agency" has the same meaning as "administrative agency" in rule 5160:1-1-01 of the Administrative Code.

 

"PACE"  means  "the  program  of  all-inclusive  care  for  the  elderly,"  which  is established by 42 C.F.R. Part 460 (October 1, 2015).

 

 

"PACE organization" means an entity that provides services to participants under a PACE program agreement with CMS and ODA.

"Participant" means a person who receives services through PACE.

Effective:                                                             08/01/2016

Five Year Review (FYR) Dates:                         04/18/2016 and 08/01/2021

CERTIFIED ELECTRONICALLY

Certification

06/23/2016

Date

Promulgated Under:                           119.03

Statutory Authority:                           173.01, 173.02, 173.50

Rule Amplifies:                                  173.50; 42 C.F.R. 460.6 (October, 2015 edition) Prior Effective Dates:                                                 03/28/2009, 02/16/2012, 02/17/2013, 12/19/2013