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.

(Source:  Amended at 38 Ill. Reg. 11519, effective May 15, 2014)