89 Ill. Adm. Code 240.1110
Participant Transfer Request - Provider to Provider - No Change in Service
Section 240
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.