GroundRules
12VAC30-50-360: PACE sanctions
Where this section sits in the code
- Title 12. Health
- Agency 30. Department of Medical Assistance Services
- Chapter 50. Amount, Duration, and Scope of Medical and Remedial Care Services
- Part III. Amount, Duration, and Scope of Services
A. DMAS shall apply sanctions to providers for violations of PACE contract provisions or federal or state law and regulation.
B. Permissible state sanctions shall include, but need not be limited to, the following:
1. A written warning to the provider;
2. Withholding all or part of the PACE provider's capitation payments, or retracting all or part of any reimbursement previously paid;
3. Suspension of new enrollment in the PACE plan;
4. Restriction of current enrollment in the PACE plan; and
5. Contract termination.
Collected 2026-09-14T04:50:56Z. Source file · JSON