89 Ill. Adm. Code 240.1665
Contract Actions for Failure to Comply with Community Care Program Requirements
Section 240
Section 240.1665 Contract
Actions for Failure to Comply with Community Care Program Requirements
The Department may impose one or
more of the following contract actions upon any CCP provider or contracted CCU that
fails to comply with Department rules or contract/Provider Agreement
requirements, including any statements made on the CCU Proposal or the
provider's application for certification. These actions include:
a) prohibition of specified staff from serving CCP participants
(imposed when the Department finds that a worker, case manager, supervisor or
other designated staff fails to comply);
b) purchase of a limited financial audit (imposed when the
Department finds that a provider or CCU has failed to adhere to the fiscal
requirements specified in this Part);
c) suspension of referrals for up to 90 days;
d) transfer of a portion of the participants served under the
contract or Provider Agreement;
e) training of staff;
f) termination of Provider Agreement or CCU contract and transfer
of all participants;
g) requiring a review by the provider or CCU of all or a
specified subset of files and provider or CCU certification of corrective
action;
h) requiring the provider or CCU to contract with an outside
management firm to evaluate program management and to implement recommendations
for improvement as provided in the evaluation and negotiated with the
Department;
i) suspending all or a portion of CCP payments until the action
is corrected;
j) deducting overpayments to provider or CCU from future
Provider or CCU Requests for Payment or requiring the provider or CCU to
reimburse the Department;
k) refusing to accept a proposal from a CCU or to enter into a
Provider Agreement with the provider in one or more specified areas open for
procurement; and/or
l) taking any other action the Director determines to be
appropriate to the non-performance circumstances.