Section 240.1645  Objection to Certification Decision

a)         A provider may file an objection, in limited circumstances, if a certification request is denied by the Department.

b)         Examples of circumstances that do not constitute an appealable basis for objection include:

1)         timing of initiation of certification process by the Department;

2)         termination of eligibility by closure of the file due to a provider's failure to comply with time frames for submitting a certification request under Section 240.1600(b);

3)         new supporting documentation to establish eligibility for certification or recertification as a service provider under the CCP following failure to comply with time frames for submitting material requested by the Department;

4)         issues upon which the Department has already made a final administrative decision as a result of a previous objection or contract action involving the provider;

5)         issues upon which an independent trier of fact has made a final determination or issued an order;

6)         disputes as to service rates or the underlying methodology for calculating those rates;

7)         duration of a service provider certification;

8)         timing of the Provider Agreement process by the Department; or

9)         other matters of general applicability that are not specifically adverse to the provider.

c)         Procedures for Filing an Objection

1)         An objection regarding a certification decision must be in writing and must be received at the Department's Springfield office on or before the tenth calendar day after the date of the applicant's receipt of the notice of the objectionable action.  If the objection is not received before the close of business on the tenth calendar day, the objection shall be disregarded.

2)         Each objection must contain a full and concise statement of the facts and circumstances of the action that is alleged to be objectionable, legally or otherwise, and a statement of the relief sought. 

A)        The Department may request additional details at any time.

B)        Failure to supply any information requested by the Department will be cause for dismissal of the objection.

d)         Upon receipt of written objection, the Department shall immediately review the certification decision in question and shall issue a written response.  The certification decision shall not be considered final until any relevant objections are resolved.

e)         The decision of the Director is final and shall be sent by mail or email.

(Source:  Amended at 48 Ill. Reg. 11053, effective July 16, 2024)