Ill. Admin. Code tit. 89 § 240.1110

Current through Register Vol. 48, No. 36, September 6, 2024

Section 240.1110 - Participant Transfer Request - Provider to Provider - No Change in Service

a) The Department, a CCU or a participant/authorized representative may request a transfer for provision of CCP services from one provider to another provider, within the same service area, and without any change in service needs. The transfer request may be initiated by verbally advising the CCU of the desired change in provider. The CCU shall verbally advise the participant of the provider choices available. The CCU shall complete a new Participant Agreement and Consent Form - Person-Centered Plan of Care, including choice of vendor based upon that verbal advice from the participant/authorized representative as to their selection.

b) Reasons for the CCU to authorize a provider to provider transfer with no change in services provided may include:

1) the needs of a participant are not being met by the current provider; or

2) the participant has exercised their right of freedom of choice and requested transfer.

c) Within five work days after the date of receipt of a verbal request to effect a transfer, the CCU shall forward a new Participant Agreement and Consent Form and new CCP Participant Agreement to the participant/authorized representative for signature.

d) Within 30 calendar days after the date of receipt of the signed Participant Agreement and Consent Form:

1) the CCU shall:

A) complete a person-centered plan of care establishing the effective date of transfer; and

B) forward:

i) the person-centered plan of care to the participant/authorized representative;

ii) a copy of the Participant Agreement - Person-Centered Plan of Care to the receiving provider on the same day the Participant Agreement - Person-Centered Plan of Care is sent to the participant; and

iii) a copy of the Participant Agreement - Person-Centered Plan of Care to transferring provider.

2) upon receipt of the provider's signature on the Participant Agreement - Plan of Care, the CCU shall place a copy of the executed Participant Agreement - Plan of Care in the CCU's participant file and a copy shall be forwarded to the participant/authorized representative.

e) The effective date of the transfer shall be within 15 calendar days after the date of the Participant Agreement - Person-Centered Plan of Care and service shall be initiated by the receiving provider without service interruption.

f) If a delay in any of the time frames established in this Section is caused by the documented action or inaction of the participant/authorized representative, time frames shall be extended by the number of calendar days of the delay.

Ill. Admin. Code tit. 89, § 240.1110

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

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

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