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 132.95 - Certified Specialty Providers (CSP) and Certified Comprehensive Community Mental Health Center (CMHC) Certification Process

Universal Citation: 59 IL Admin Code § 132.95

Current through Register Vol. 48, No. 12, March 22, 2024

a) The IMPACT portal is the enrollment site for the HFS Provider Participation Unit. Entities seeking certification as a CMHC shall request enrollment through the IMPACT portal. Any entity enrolled through the IMPACT portal may request certification from a CSA as a CSP or CMHC.

b) During the IMPACT application process, entities shall determine what population they will be serving and will be directed to the appropriate CSA to complete the certification process.

1) If an entity intends to contract for services with more than one CSA, it shall submit its certification application to the State agency that provides the most funding for community mental health services.

2) If the funding from both CSAs is equal, the provider shall submit the application to DHS.

c) The entity shall contact the CSA in writing to request the application packet.

DHS-BALC:

401 S. Clinton, 7th Floor

Chicago IL 60627

DHS.BALC@illinois.gov

DCFS:

DCFS.Medicaid@illinois.gov

d) IMPACT will issue notice of initial enrollment to the provider and the CSAs within 10 days. The CSA shall review the provider information provided through the IMPACT portal.

e) Upon review of all submitted materials, the CSA shall determine that:

1) The submitted materials meet the standards of a CSP or CMHC established in Subparts B and C; or

2) The submitted materials do not meet the standards established in Subparts B and C.

f) If the CSA determines that the submitted materials meet the standards established in Subparts B and C, the CSA shall issue a provisional certification determination to HFS, if applicable, and the entity within 30 days after reviewing materials and reaching a determination.

1) The effective date of provisional certification shall indicate the type of certification awarded and the date that the application was approved.

2) A provisional certificate shall be in effect for 12 months, unless extended by the CSA.

3) An entity issued a provisional certificate shall enroll in any information system required by the CSA.

g) If the CSA determines that the submitted materials do not meet the standards established in Subparts B and C, the CSA shall issue the applicant a Notice of Violation within 30 days after the review. The NOV shall provide the entity 30 days to remedy the violations.

1) If the entity intends to proceed with certification as a CSP or CMHC, the entity may submit notice and documentation of corrections to the CSA to address all identified violations by the due date indicated on the NOV.

2) If the notice and documentation of corrections is found to address all of the identified violations included in the NOV, then the CSA shall continue with the certification process outlined in this Part.

3) If the entity pursuing CMHC certification fails to supply the necessary materials or the supplied materials fail to meet the standards detailed in this Part, the CSA shall notify HFS and the entity in writing of the entity's failure to obtain certification as a CMHC and right to appeal pursuant to Section 132.110.

4) If the entity pursing CSP certification fails to supply the necessary materials or the supplied materials fail to meet the standards detailed in this Part, the CSA shall notify the entity in writing of the entity's failure to obtain certification as a CSP and right to appeal pursuant to Section 132.110.

h) The CSA may supply technical assistance through the certification process as deemed necessary.

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