SAN DIEGO PACE

Owner

Goods & Services

Health utilization, review, and cost containment services; medical cost management of healthcare benefits for Program of All-Inclusive Care for the Elderly (PACE) participants; Primary care and specialty care doctor referrals for PACE participants; medical provider network management, medical claims administration and processing, adult day healthcare services, cost management for the dental and vision benefits for PACE participants; Referral services with respect to dental and vision care providers

Transportation services, namely, providing individual and group transportation to adult or elderly persons by van, car, or bus

Educational Services, namely, Healthcare Education, Healthy Living, and Nutritional Counseling and Meal Planning. Healthcare education in the form of information on primary care and preventative care services and healthy living. Healthcare education regarding Medicare, Medi-Cal and PACE healthcare benefits. Nutritional Counseling and Meal Planning provided in personally tailored and monitored meal planning for each participant of the Program of All-Inclusive Care for the Elderly. Entertainment Services provided in the form of group social settings for art classes, dance, gardening, cooking, yoga, and fitness classes and other group social activities for the elderly

Providing case management services, namely, coordinating physical, social, and psychological services for individuals in the Program of All-Inclusive Care for the Elderly; Social Work support services to senior persons in Program of All-Inclusive Care for the Elderly, namely, emotional and family need services

Healthcare services, namely, Primary Care, Specialty Care, Transportation, Home Care, Podiatry, Speech, Visual and Occupational Therapy, Hospice, Acupuncture, Dental, Optometry, Ophthalmology, Audiology, Chiropractic, Pulmonology, Radiology, Laboratory, Respiratory Care, Dialysis, Physical Therapy, Occupational Therapy, Nursing Care, OBGYN, Cardiology, Ontology, Geriatrics, Pharmacy, Rehab and Durable Medical Equipment, Inpatient and Outpatient Care, Pain Management, Nutrition services, Adult Daycare Services, and Behavioral Health

Respite care services in the nature of adult day center care; Providing adult day and elderly care centers; Providing elder care for members of the Program of All-Inclusive Care for the Elderly

Organization and health plan benefit administration for Program of All-Inclusive Care for the Elderly (PACE) beneficiaries. Medical claims administration, adjudication and processing for PACE. PACE beneficiary enrollment services