Illinois Administrative Code
Title 59 - MENTAL HEALTH
Part 132 - MEDICAID COMMUNITY MENTAL HEALTH SERVICES PROGRAM
Subpart D - ENROLLMENT AND CERTIFICATION REQUIREMENTS OF CERTIFIED COMPREHENSIVE COMMUNITY MENTAL HEALTH CENTERS AND CERTIFIED SPECIALTY PROGRAMS
Section 132.110 - Appeal of Certification Determination
Universal Citation: 59 IL Admin Code ยง 132.110
Current through Register Vol. 48, No. 12, March 22, 2024
a) An entity may appeal the following actions detailed in this Part:
1) Refusal to issue a
provisional certification;
2)
Refusal to issue full certification;
3) Refusal to retain certification;
or
4) Revocation of
certification.
b) If the CSA determines that provisional certification or certification shall not be issued, that certification shall not be retained, or that an entity's certification shall be revoked, the CSA shall send written notice to DHS and the entity within 30 days after that determination. The notice shall contain the specific requirements with which the entity has not complied, the CSA's proposed action, and the entity's rights as follows:
1) If the entity chooses to appeal the CSA's
decision, the entity shall submit a written request for a hearing to the DHS
Bureau of Hearings, within 20 days after the date of the notice.
2) If an appeal is initiated by a CMHC with
provisional certification or certification, the entity may continue to provide
services pending a final administrative decision unless the entity's continued
provision of services would present an imminent risk of harm.
3) Hearing Process
A) The DHS rules at 89 Ill. Adm. Code 508
(Administrative Hearings) shall apply.
B) The sole issue at the hearing shall be
whether the provider is in compliance with certification requirements set forth
in this Part or meets the criteria for revocation of certification set forth in
this Part.
C) The burden of proof
in hearings conducted pursuant to this Section shall be on the appealing
entity.
4) If the final
administrative decision pursuant to appeal is that certification shall not be
issued or retained, or that an entity's certification shall be revoked, the
notice shall specify that the decision shall take effect upon receipt by the
entity and that the entity shall not be certified as a CMHC during the pendency
of any proceeding for judicial review of the hearing decision, except by court
order.
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