Section 240.1660  Provider Performance Reviews

a)         Providers under contract to the Department must comply with federal, State and local laws, regulations, Department rules and the contract requirements.  When the provider signs the contract, this signature shall be the provider's certification that all applicable laws, rules and regulations, contract requirements, and statements included in the Provider Proposal shall be complied with.  The Department shall have the authority to conduct performance reviews of a contracted provider agency at any time during the course of the provider's contract period.  Any findings and/or contract actions resulting from a performance review may be appealed (see Section 240.1661).

b)         The Provider Performance Review consists of a sample of rules, of RFP requirements, and of cases that will be reviewed for performance.

c)         If non-performance findings result from the Provider Performance Review, the provider shall receive a written report of the findings and have a specified period of time for adherence.  The allowable time period shall be relevant to the classification of the violation and the applicable corrective action time frames specified in Section 240.1650.

d)         If non-performance findings result from the follow-up review, the Department may impose one or more of the contract actions specified in Section 240.1665.

e)         The Department may initiate the termination of the provider agreement after three consecutive performance reviews resulting in non-compliance findings as indicated on the written report.

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