Section 240.1957  Fixed Unit Rates of Reimbursement for Automated Medication Dispenser Service

AMD service providers executing a contractual agreement with the Department pursuant to Section 240.1600 shall be uniformly reimbursed for the provision of AMD units at fixed unit rates of reimbursement established by the Department. The reimbursable units of AMD service shall be as follows:

a)         Installation, Initial Training and Removal

The Department shall pay a 1-time installation fee at a fixed unit reimbursement rate established by the Department for the installation and initial training of the participant/authorized representative/responsible party of the AMD unit in the participant's residence.  The Department shall not pay any fee for expenses incurred by the AMD provider if service could not be provided due to either the participant's absence or the participant's refusal to admit the AMD provider's employee into the residence.  The Department shall not pay any fee for removal of the AMD unit. 

b)         Monthly Service

The Department shall pay a monthly service fee per participant at a fixed unit reimbursement rate established by the Department for providing AMD service that includes maintaining administrative and technical support to program machines; providing 24 hour technical assistance and additional training; signal monitoring, troubleshooting, machine maintenance, repair and replacement; notifications to the responsible party on missed medication doses and power outage; tracking and analyzing data; and providing reports as requested by the Department.  The Department will not pay for the cost of maintaining telephone service for the participant or any associated charges or fees.

c)         The rates will be reviewed annually, at a minimum, and adjustments may be made to conform to the appropriation, service requirements and/or changes in federal and State laws, regulations and/or rules affecting the service.

d)         In establishing the rates of reimbursement, the Department may consider any of the following factors:

1)         appropriation levels;

2)         cost information provided by the providers; and/or

3)         current market conditions and trend analyses.

e)         Upon written notification from the Department of a change in the rates of reimbursement, an AMD provider may exercise its 60 calendar day termination rights if the AMD provider no longer wishes to provide services thereafter at the new rates of reimbursement.

(Source:  Amended at 42 Ill. Reg. 20653, effective January 1, 2019)