Ill. Admin. Code tit. 89 § 240.945

Current through Register Vol. 48, No. 44, November 1, 2024

Section 240.945 - Notification of a Change in Service

a) Any participant whose CCP services are being changed in the following manner shall be advised of the change by written notice: change of service type; reduced amount of service; increased amount of services; or termination.

1) The written notice shall be sent to a participant/authorized representative by mail, email (if consented to), or given personally.

2) The notice shall clearly state the reason for the action being taken.

3) The participant/authorized representative shall be notified of the action being taken no later than 15 calendar days after the date of assessment or redetermination and the action shall be effective no sooner than 15 calendar days after the date of the notice if the action is adverse to the participant. This time frame does not apply to termination as a result of the non-cooperative act specified in Section 240.355.

4) In instances involving an automatic, non-discretionary change in eligibility, rates or benefits required by federal or State statute or regulation, the participant/authorized representative will be notified of the action being taken at least 15 calendar days prior to the implementation by the CCU of the change affecting the participant. The action will be effective no sooner than 15 calendar days after the date of notice if the action is adverse to the participant.

5) In the event of a death, the termination shall be effective the date of the participant's death. The form shall be dated and mailed/hand-delivered upon the Department or the CCU being informed of the death.

b) CCP services may be changed, reduced or terminated at the request of the participant/authorized representative and do not require the 15-calendar day notice period under the following circumstances:

1) the participant/authorized representative provides the CCU with a signed statement that the change, reduction or termination is at their request;

2) the CCU, participant/authorized representative and provider mutually agree to the initiation of the change, reduction or termination on the agreed upon date (which may be less than the required 15 calendar days after the date of the notice to the participant/authorized representative);

3) a written notice is provided to the participant/authorized representative prior to the initiation of the change or reduction. The notice shall indicate the agreed upon effective date; and

4) the CCU has documented all of the requirements of this subsection (b) and placed the participant's statement in the case record.

c) When an assessment or reassessment for services requires an increase, or no change in service, the participant/authorized representative and the provider shall be notified in writing. The notice shall be mailed or emailed within 15 calendar days after the date of the assessment or reassessment.

Ill. Admin. Code tit. 89, § 240.945

Amended at 35 Ill. Reg. 8919, effective June 2, 2011

Amended at 38 Ill. Reg. 14230, effective 6/25/2014

Amended at 42 Ill. Reg. 20653, effective 1/1/2019

Amended at 48 Ill. Reg. 11053, effective 7/16/2024