Section 5160-36-05 - Program of all-inclusive care for the elderly (PACE): care coordination(A) Each PACE organization shall establish and maintain at each PACE center an interdisciplinary team to assess the care and service needs of participants. The composition, qualifications, and activities of the interdisciplinary team shall be consistent with 42 C.F.R. Part 460 as in effect on October 1, 2019. (B) PACE organizations shall ensure that all participants have access to all medically necessary services including, but not limited to, services covered by Ohio's medicaid program, in addition to those prescribed in 42 C.F.R. Part 460.92 as in effect on October 1, 2019 to 42 C.F.R. Part 460.96 as in effect on October 1, 2019. (1) Services provided shall be sufficient in their amount, duration and scope to meet the participant's medical, physical, emotional, and social needs as identified in the comprehensive assessment to achieve the measurable outcomes identified in the participant's plan of care.(2) Services provided shall be reflected in the participant's plan of care unless the services are an emergency service.Ohio Admin. Code 5160-36-05
Effective: 1/1/2020
Five Year Review (FYR) Dates: 10/15/2019 and 01/01/2025
Promulgated Under: 119.03
Statutory Authority: 5164.02
Rule Amplifies: 5162.35, 173.50
Prior Effective Dates: 03/28/2009, 01/01/2015