TITLE 89: SOCIAL SERVICES
CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
SUBCHAPTER d: MEDICAL PROGRAMS
PART 140 MEDICAL PAYMENT
SECTION 140.855 ADMINISTRATIVE CLAIM REVIEW AND RECONSIDERATION PROCEDURE
Section 140.855 Administrative Claim Review and Reconsideration Procedure
a) The Department may reject all or any portion of a claim for federal reimbursement that is not in compliance with State or federal law, regulation, policy or applicable intergovernmental or interagency agreement. The claiming entity may request an informal review and reconsideration of the Department's decision to reject all or any portion of a claim for federal administrative reimbursement.
b) The Department provides the following review procedure by which the State agency or local government entity may seek an informal review and reconsideration of the Department's decision to reject all or any part of a request for federal administrative reimbursement:
1) The request for review must be submitted in writing to the Department.
2) The request for review must be received by the Department within 30 days after the date of the Department's notice to the claiming entity of a Department adjustment to a claim.
3) A request for review from the claiming entity shall include a clear explanation of the reason for the request and documentation supporting the desired correction.
4) Review shall be limited to technical errors in calculations related to the cost allocation plan.
5) The Department shall notify the claiming entity, in writing, of the results of the review within 30 days after receipt of the claiming entity's request for review.
(Source: Section repealed at 18 Ill. Reg. 18059, effective December 19, 1994; new Section added at 25 Ill. Reg. 11880, effective September 1, 2001)