89 Ill. Adm. Code 6860.686.240
Payment Information for Homemaker Service Providers
Section 686
TITLE 89: SOCIAL SERVICES
CHAPTER IV: DEPARTMENT OF HUMAN SERVICES
SUBCHAPTER d: HOME SERVICES PROGRAM
PART 686 PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT
SECTION 686.240 PAYMENT INFORMATION FOR HOMEMAKER SERVICE PROVIDERS
Section 686.240 Payment Information
for Homemaker Service Providers
a) Payment
information for all Homemaker Service Providers
1) Payment for Homemaker Services shall be at the rate specified
in the rate agreement signed by HSP and the approved Homemaker Service Provider.
2) Services shall be paid in accordance with the time recorded by
the Homemaker employee pursuant to the Service Plan (see 89 Ill. Adm. Code
676.30) developed for the customer.
3) Homemaker Service Providers shall submit monthly billings for
approved services provided the previous month and monthly progress reports for
each customer served by the Homemaker Service Provider for the month being
billed.
4) Payment for Homemaker Services shall be allowed only for those
hours services are being provided to the HSP customer. No payment shall be
claimed for those periods that the Homemaker employee spends traveling, in
conferences, etc., or for expenses incurred by the Homemaker employee.
5) By
accepting any payment under HSP, a Homemaker Service Provider agrees to repay
the State of Illinois if:
A) the
total revenue from the monthly billings exceeds the actual, approved documented
services under this Section for the reporting period;
B) an
error occurred in the calculation of the monthly billing submitted to HSP and
the provider was overpaid;
C) the
Homemaker Service Provider received payment for services during a time the
provider was determined ineligible to provide services under HSP; or
D) the
Homemaker Service Provider misspent HSP funds or received funding from HSP
while participating in fraudulent activity.
b) Additional
Payment Information for Homemaker Service Providers with the Enhanced Rate for
Health Insurance Costs
1) If a
Homemaker Service Provider is determined eligible for the enhanced rate for
health insurance costs, HSP will thereafter calculate the appropriate payment
based on the number of units of Homemaker Service accepted as billed for the
eligible dates of service.
2) A
Homemaker Service Provider that makes a switch between a Type 1 and a Type 2
plan is not entitled to any retroactive payments for a period of time preceding
the date on which benefits are actually available under the new plan.
3) No
Homemaker Service Provider is entitled to a duplicate payment for the same
period of time or for the same units of Homemaker Service accepted as billed
per contract.
4) By
accepting any payment under HSP, a Homemaker Service Provider agrees to repay
the State of Illinois if:
A) the
total revenue from the enhanced rate for health insurance costs exceeds the
actual, documented expenses for its health insurance costs under this Section
for the reporting period;
B) an
error in eligibility of a Homemaker Service Provider, or the amount of revenue
from the enhanced rate for health insurance costs, or the amount of the health
insurance costs is subsequently determined by the Homemaker Service Provider or
HSP; or
C) the
Homemaker Service Provider misspent HSP funds or received funding from HSP for
the enhanced rate for health insurance costs while participating in fraudulent
activity.