Ill. Admin. Code tit. 89, § 356.30 - Types of Reimbursement Made by the Department
a) The Department will reimburse providers
through payments made according to standard reimbursement levels and through
reimbursement levels which are specifically negotiated through contract. The
Department shall notify the provider in writing of the reimbursement
rate.
b) Reimbursement according to
rate reimbursement levels.
1) The Department
shall adopt the rates promulgated by another state agency where that agency is
the primary purchaser of service. This shall include hospitals, nursing homes,
community living facilities, day care providers and individual medical care
providers.
2) The Department shall
calculate standard rates in accordance with Section 5a of the Children and
Family Services Act [20 ILCS
505/5a ]. This calculation will consider the minimum
wage law, U.S. Department of Agriculture cost statistics, the age of the
children to be served, the nature of the children's service needs, the
experience and background of the individual provider, and the type of service
provided. Reimbursement rates for these providers are set by the Department
utilizing market surveys and independent cost analyses in order to arrive at a
reasonable cost for specific units of service unless otherwise specified in
this Part. Services for which the Department shall calculate standard rates
include, but are not limited to, agency foster care and agency adoption
services.
3) The Department shall
calculate individual program rates for child care institutions, group homes,
independent living arrangements and maternity centers subject to the provisions
of Section
356.50.
c) Reimbursement according to
negotiated contracts.
Agencies that provide services which reflect a significant variance in the type of service and type of client are reimbursed according to reasonable cost standards as established by the Department's approved rate methodology. See Section 356.50.
Notes
Amended at 24 Ill. Reg. 7692, effective June 1, 2000
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