Section 240.1661  Provider and Case Coordination Unit Right to Appeal

The provider and Case Coordination Unit (CCU) have the right to appeal any finding and/or contract action (refer to Section 240.1665 of this Part) resulting from a performance review (refer to Sections 240.1660 and 240.1720 of this Part).

a)         Upon receipt of the Provider or CCU Performance Review report of non-performance findings and the written notification of contract action(s) to be taken, a provider or CCU wanting to appeal must do so in such a manner that the appeal is received at the Department's Springfield Office on or before the 15th work day from the date of the notice.  If the appeal is not received before the close of business on the 15th work day, the appeal shall be disregarded.

b)         Appeals shall be submitted in the manner and form specified by the Department and shall be addressed, delivered or mailed to:

Director

Attention:  General Counsel

Illinois Department on Aging

421 East Capitol Avenue, #100

Springfield, Illinois 62701-1789

c)         General Counsel, with appropriate Department staff, will review the appeal and make a recommendation to the Director for final decision.

1)         If the finding and/or contract action is determined by the Director to be valid, the finding/action shall be upheld/implemented.

2)         If the finding and/or contract action is determined by the Director to be invalid, the appeal shall be upheld and the finding/action shall be modified or expunged, in whole or in part, with evidence placed in the provider or CCU file.

d)         The Director may determine that the circumstance(s) causing the contract action(s) warrant(s) a hearing which shall be conducted at the Illinois Department on Aging, 421 East Capitol, Springfield, Illinois.

1)         The provider or CCU may bring appropriate representation and written appeal data to the hearing.

2)         Appropriate Department staff shall be in attendance at the hearing.

e)         All hearings shall be conducted in accordance with Department hearing rules (89 Ill. Adm. Code 220.500 through 220.520).

(Source:  Amended at 23 Ill. Reg. 5642, effective May 1, 1999)