The PACE Organization Application Process in 42 CFR Part 460 (CMS-10631)

OMB 0938-1326

OMB 0938-1326

Initial application requirements for the PACE program are currently set forth in 42 CFR 460.12 and in the PACE Manual, Ch. 17. Until recently, the submission of initial and SAE PACE applications and supporting information was in paper format. These applications are often hundreds of pages long, expensive to reproduce and transmit, and administratively inefficient, as staff reviewing different parts of the application are located in different physical locations and must receive hard copies of the material. However, beginning in 2016, initial PACE applications are being submitted via a new automated, electronic submission process. As with initial applications, an application also must be submitted for a PO that seeks to expand its service area and/or add a new service site, and with OMB approval, an automated application process will now also be required of PACE organizations submitting service area expansion applications. In pursuing this new information collection package, we are extracting this component only from the existing OMB approval for the PACE program (CMS-R-244, OMB Control Number 0938-0790).

The latest form for The PACE Organization Application Process in 42 CFR Part 460 (CMS-10631) expires 2023-04-30 and can be found here.

OMB Details

Application Requirements (POs)

Federal Enterprise Architecture: Health - Health Care Services

Form CMS-10631HPMS_ Expansion PACE ApplicationFillable PrintableForm and instruction
Form CMS-10631PACE ApplicationFillable PrintableForm and instruction
Form CMS-10631HPMS_ Initial PACE ApplicationFillable PrintableForm and instruction

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