Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 104 - PRACTICE IN ADMINISTRATIVE HEARINGS
Subpart D - RULES FOR JOINT DEPARTMENT ACTIONS AGAINST SKILLED NURSING FACILITIES AND INTERMEDIATE CARE FACILITIES PARTICIPATING IN THE MEDICAID PROGRAM
Section 104.330 - Facilities Certified Under Both Medicare and Medicaid
Universal Citation: 89 IL Admin Code ยง 104.330
Current through Register Vol. 48, No. 12, March 22, 2024
a) If a SNF is participating, or seeking to participate in both Medicare and Medicaid, and if the basis for denial, termination or non-renewal of certification and participation in Medicaid is also a basis for the denial, termination or non-renewal of participation in Medicare, the Department shall notify the facility that:
1) The facility is entitled to the review
procedures specified or referred to in 42 CFR 405, Subpart D, in lieu of the
procedures specified or referred to in these rules; and
2) A final decision entered under the
Medicare review procedures shall be binding on the issue of certification for
purposes of Medicaid participation.
b) The Department of Public Aid may continue to seek to deny, suspend or terminate participation in the Medical Assistance Program on the basis of non-certification issues for facilities participating or seeking to participate under both Medicare and Medicaid, pursuant to 89 Ill. Adm. Code 140.14 and 140.16.
Disclaimer: These regulations may not be the most recent version. Illinois may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
