Participant Rights & Responsibilities

Participant Rights

As a participant of K-day PACE, you have the right to:

• Be treated with respect and dignity at all times.
• Receive comprehensive health care in a safe and accessible environment.
• Participate in decisions about your care and receive clear explanations about your treatment options.
• Request and receive a copy of your health information.
• Privacy and confidentiality in all matters related to your medical care.
• Voice complaints, grievances, and appeals without fear of retaliation.
• Disenroll from the program at any time.

For a full list of your rights, please download [The Participant Rights Document]

Participant Responsibilities

As a participant of K-day PACE, you are expected to:

• Work with your interdisciplinary care team to develop and follow your care plan.
• Use K-day PACE or K-day PACE–approved providers for all medical services, except in emergencies.
• Notify us promptly if you move out of the service area or seek non-authorized care.

Disenrollment

You may disenroll from K-day PACE at any time. If you choose to leave the program, we will assist you in transitioning to other healthcare coverage options, including Medicare and/or Medicaid services available outside of PACE.

For a full disenrollment contents, please download [The Disenrollment Document]

Grievances & Appeals

You have the right to file a grievance or appeal if you are dissatisfied with your care or services.

How to File a Grievance:

• Call us at (213) 757-2080 or Toll Free (888) 322-1530, TTY: (213) 757-2083
• Mail to:
  
  K-day PACE – Grievance Department
  
  303 South Union Avenue, Los Angeles, CA 90057
• Fax: (213) 757-2083
• Submit in person at our center or online via [Grievance Form]

Or file with:

• U.S. Department of Health and Human Services, Office for Civil Rights
• Online: https://ocrportal.hhs.gov (“This connects to an external link.”)
• Phone: 1-800-368-1019 | TTY: 1-800-537-7697

Appeals:

If K-day PACE denies, reduces, or ends a service you believe you need, you have the right to appeal orally or in writing.

You may also appoint a representative by submitting [CMS Form-1696].

Privacy & Personal Information Notice

 K-day PACE is committed to protecting your personal information and ensuring compliance with all applicable laws, including CMS regulations and HIPAA.

Restriction of Services

Except in an emergency, participants must receive all covered services from K-day PACE or from providers authorized by the K-day PACE care team. If a participant chooses to obtain services that are not authorized by the interdisciplinary care team or provided outside of the PACE program, those services will not be covered.

Liability for Costs

Participants are financially responsible for the cost of any unauthorized services received without prior approval from the K-day PACE care team, or from providers outside of the K-day PACE network, except in the case of emergency services. Unauthorized services are not covered by Medicare or Medicaid through K-day PACE, and participants will be liable for the full cost.

Nondiscrimination & Language Assistance

K-day PACE complies with Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, or gender identity. Free aids and services are available, including language assistance and auxiliary aids, to ensure equal access.

For help, contact us at (213) 757-2080, Toll Free (888) 322-1530, TTY (213) 757-2083.