Section 230.200  Costs and Fees

a)         The Department may charge a fee to any health care facility or program applying to be certified to participate in the Medicare program or in the Medicaid program to cover the costs associated with the application, inspection and survey of the facility or program and processing of the application, including personnel costs.  The Department's decision to charge a fee will be based on whether the inspection and survey and processing costs are reimbursed to the State by the federal government.  (Section 55.82 of the Act)

b)         The costs associated with conducting health care facility or program initial certification inspections shall be calculated based on the following:

1)         Number of hours to conduct survey for facility or program type, i.e., long-term care facility, home health agency, rural health clinic, end-stage renal dialysis center, hospice program, hospital, physical or occupational therapist in independent practice, occupational therapy, speech therapy, outpatient physical therapy, ambulatory surgical treatment center, portable x-ray unit;

2)         Personnel costs (i.e., average salaries of surveyors and retirement, insurance, and social security benefits);

3)         Travel costs;

4)         Processing of the application. (Section 55.82 of the Act)

c)         The fee charged to a health care facility or program for an initial certification inspection shall be determined by the actual average cost for conducting surveys for that type of program or facility during the previous 12 months.

d)         If a fee is charged, it shall be reduced by the amount reimbursed to the State by the federal government for surveys for that type of program or facility during the previous quarter of the federal fiscal year.

e)         The Department shall notify the applicant of the amount of any fee to be charged within 30 calendar days after receiving a completed application.

f)         The fee shall be paid by the facility or program before the application is processed.  (Section 55.82 of the Civil Administrative Code of Illinois) If the applicant does not submit the fee to the Department within 30 calendar days after receipt of the notice, the applicant shall be considered to have declined the certification inspection.

g)         The Department shall not refund initial certification inspection fees.

h)         If unforeseen circumstances affecting the facility or program occur after the fee has been paid, the Department shall postpone the inspection and shall not charge an additional fee.  Such circumstances may include, but not be limited to, a natural disaster or a loss of essential services.