Ill. Admin. Code tit. 89, § 147.346 - Appeals of Nursing Rate Determination

a) Appeals must be submitted in writing to the Department no later than 30 days after the date of the Department's notice to the facility of the rate calculation resulting from the on-site review. The revised rate shall be processed into the payment system 30 days after the date of the Department's notice in order to allow time for submission of appeals.

b) The appeal shall contain clear and relevant supportive documentation. The facility must succinctly address the area being appealed. Additional documentation not presented to the HFS review team during the review, or at the time of exit, will not be considered in the appeal process.

c) The Department will rule on all appeals within 120 days after the date of appeal, except in rare instances where the Department may require additional information from the facility. In this case, the response period may be extended.

d) The appeal and supportive documentation will go through several stages of review within the Department to ensure fairness, objectivity and consistency with the appeal determination. The rate resulting from the appeal determination will become effective the first day of the applicable quarter.

Notes

Ill. Admin. Code tit. 89, § 147.346

Added at 38 Ill. Reg. 12173, effective 5/30/2014