Section 132.45  Compliance with Certification Requirements

a)         Medicaid community mental health service providers shall be recognized according to levels of compliance with standards as set forth in this Part.  Providers with findings of Level 1 and 2 will be considered to be in good standing with the State agency.  The levels of compliance are:

1)         Level 1 – Compliant:  No written Plan of Correction will be required of the provider (90-100% compliance).

2)         Level 2 – Substantial compliance:  A Notice of Deficiencies is issued.  The provider shall submit a written Plan of Correction to address the identified deficiencies.  Within 12 months after the date that a Plan of Correction is approved, the Certifying State Agency shall conduct a review to evaluate the provider's implementation of the Plan of Correction.  If the provider fails to submit and implement a Plan of Correction within the designated time frame, the Certifying State Agency may revoke the provider's certification to provide services pursuant to this Part (75-89% compliance).

3)         Level 3 – Minimal compliance:  A Notice of Deficiencies is issued.  The provider shall submit a written Plan of Correction to address the identified deficiencies.  After 90 days from the date that a Plan of Correction is approved, the Certifying State Agency shall conduct a review to evaluate the provider's implementation of the Plan of Correction.  The provider's level of compliance must reach at least Level 2 to demonstrate implementation of the Plan of Correction.  If the provider fails to submit and implement a Plan of Correction within the designated time frame, the Certifying State Agency may revoke the provider's certification to provide services pursuant to this Part (50-74% compliance).

4)         Level 4 – Unsatisfactory compliance:  A Notice of Deficiencies is issued.  The provider shall submit a written Plan of Correction to address the cited deficiencies.  After 60 days from the date that a Plan of Correction is approved, the Certifying State Agency shall conduct a review to evaluate the provider's implementation of the Plan of Correction.  The provider's level of compliance must reach at least Level 3 to demonstrate implementation of the Plan of Correction.  After 90 days from the date that the Plan of Correction was approved, the provider's level of compliance must reach at least Level 2 to demonstrate implementation of the Plan of Correction.  If the provider fails to submit and implement a Plan of Correction within the designated time frames, the Certifying State Agency may revoke the provider's certification to provide services pursuant to this Part (under 50% compliance).

b)         When a written Plan of Correction is required, the provider shall submit the Plan of Correction within 30 days after receipt of the Notice of Deficiencies.

(Source:  Amended at 32 Ill. Reg. 9981, effective July 1, 2008)