89 Ill. Adm. Code 240.945
Notification of a Change in Service
Section 240
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.