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• Specialized therapies • Personal care services • Nutrition counseling • Meals • Transportation • Prescriptions

5. If at any time, PACE determines a beneficiary can no longer be cared for in the home, the PACE organization may place the PACE beneficiary in another health care setting for a short period of time, or if necessary, it can be a permanent placement. Temporary and/or permanent placement in another health care setting such as a nursing facility does not change an individual’s PACE enrollment status or capitation rate. The PACE organization is responsible for payment of cost of care.

B. PACE Program Enrollment Requirements

1. An individual must be living in the approved geographic area of the PACE organization;

2. Be at least 55 years old or older

3. Be determined by the PACE organization to be able to be cared for safely in the community

4. Meet the State’s eligibility criteria for nursing home level of care.

C. PACE Program Enrollment Process

1. Applications for PACE enrollment are initiated and processed by the PACE organization. Once PACE approves enrollment, the applicant must sign a Participant Enrollment Agreement. PACE enrollment is always the first day of the month following the month the Participant Enrollment Agreement is signed and received by the PACE organization.

2. Once enrolled for PACE, the beneficiary is enrolled for the next year unless they terminate enrollment. PACE beneficiaries are re-assessed annually by the PACE organization.

3. “Lock-In” Provision

"Lock-in" means once enrolled in PACE, health care services will be provided through the PACE organization. Services will be approved by the members of the PACE Interdisciplinary Team. If a PACE beneficiary receives medical services that have not been approved by the PACE Interdisciplinary Team, the beneficiary may be personally responsible for paying the cost of those services. If a PACE beneficiary receives medical services from a non-PACE medical provider without prior authorization (with the exception of