Requirements for PACE Entities

Medicare and Medicaid; Programs For All-Inclusive Care For The Elderly (PACE) Contained in 42 CFR Part 460 (CMS-R-244)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0790 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	Requirements for PACE Entities	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 460.82(f) 42 CFR 460.122(b) and (h) 42 CFR 460.116(c) 42 CFR 460.120(b) and (e) 42 CFR 460.124 42 CFR 460.132(b) 42 CFR 460.152(b)(4) 42 CFR 460.156(a) and (b) 42 CFR 460.190(a) 42 CFR 460.196(c) 42 CFR 460.201(a)(1) and (c)(1) 42 CFR 460.68(b)(1) and (2) 42 CFR 460.70(b)(1) 42 CFR 460.30(a) and (b) 42 CFR 460.71(a) 42 CFR 460.72(a)(3) 42 CFR 460.102(e) 42 CFR 460.104(c)(3)(iii)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 149	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	144,722	23,430	121,292
Annual IC Time Burden (Hours)	128,981	41,740	87,241
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.