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)

Documents and Forms

Document Name Document Type
PACE Manual.docx www.cms.gov/Regulations-and- Guidance/Guidance/Manuals/Internet-Only-Manuals- IOMs-Items/CMS019036 Instruction

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 460.104(c)(3)(iii) 42 CFR 460.82(f) 42 CFR 460.116(c) 42 CFR 460.120(b) and (e) 42 CFR 460.122(b) and (h) 42 CFR 460.124 42 CFR 460.156(a) and (b) 42 CFR 460.132(b) 42 CFR 460.152(b)(4) 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 460.72(a)(3) 42 CFR 460.71(a) 42 CFR 460.102(e)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			PACE Manual.docx	https://www.cms.gov/Regulations-and- Guidance/Guidance/Manuals/Internet-Only-Manuals- IOMs-Items/CMS019036	No		Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 156	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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	221,264	99,972	121,292
Annual IC Time Burden (Hours)	148,056	60,815	87,241
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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