The PACE Organization (PO) Monitoring and Audit Process in Part 460 of 42 CFR (CMS-10630)

42 CFR 460.190 and 460.192 described CMS’s regulatory authority to monitor, through audit or other means, the Programs for All-Inclusive Care of the Elderly (PACE). This monitoring includes review of books, contracts, medical records, patient care documentation and any other records that pertain to any aspect of services performed, reconciliation of benefit liabilities, and determination of amounts payable. CMS developed a strategy to address our oversight and audit responsibilities. We have combined both the trial year and ongoing audit protocols into one universal audit protocol that is streamlined and outcomes based to reduce the financial and administrative burdens for both CMS and PACE organizations.

The latest form for The PACE Organization (PO) Monitoring and Audit Process in Part 460 of 42 CFR (CMS-10630) expires 2023-02-28 and can be found here.