Section 360. PACE sanctions

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.

Historical Notes

Derived from Volume 25, Issue 08, eff. February 5, 2009.

Statutory Authority

§ 32.1-325 of the Code of Virginia; 42 USC § 1396.