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Requests Made prior to Initial Plan of Care

Home Requests Made prior to Initial Plan of Care

42 CFR 460.121(b)(2)

Recently, regulatory changes were made to account for requests made prior to the creation of an initial plan of care. Regulators reasoned that it was unfair to expect a PACE Organization to conduct a service determination request on a participant who has not completed initial assessments and plans of care, thus a “carve out” exception was made for this scenario. In the case that a participant requests a service prior to the finalization of the initial plan of care (often during an initial assessment), the IDT must:

  • Document the request when made, and in the initial plan of care
  • Include the request in the initial plan of care discussion with the IDT
  • Document that the request will or will not be provided (with a rationale if denied) in the initial plan of care

*An IDT may still choose to process an SDR prior to the Initial Plan of Care, and may consider doing so if a denial is likely in order to provide appeal rights.

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