- a) A request for transfer of a CCP participant from one provider to another provider within the same service area that requires a change in the services provided shall be completed by the CCU following a redetermination of need. The request may be initiated by the Department, CCU, the vendor, or the participant/authorized representative verbally or in writing to the CCU. The CCU shall complete the redetermination of need, including obtaining a completed and signed Participant Agreement and Consent Form – Person-Centered Plan of Care from the participant/authorized representative, within 30 calendar days after the date of the request unless delayed by the participant/authorized representative.
b) Reasons for a provider to provider transfer with a required change in service may include:
- 1) a change in the participant's condition; and
- 2) the provider's inability to meet the service needs of the participant, as required by the person-centered plan of care.
c) The CCU shall:
1) no later than 15 calendar days after the date of redetermination, complete in accordance with Section 240.945 and forward:
- A) the Participant Agreement − Person-Centered Plan of Care to the participant/authorized representative;
- B) a copy of the Participant Agreement − Person-Centered Plan of Care, the CCP Participant Agreement to the receiving provider on the same day the Participant Agreement − Person-Centered Plan of Care is sent to the participant/authorized representative;
- C) a copy of the Participant Agreement − Person-Centered Plan of Care to the transferring provider.
- 2) Upon receipt of the provider's signature on the Participant Agreement – Person-centered Plan of Care, a copy of the executed Participant Agreement – Person-centered Plan of Care shall be placed in CCU's participant file and a copy shall be forwarded to the participant/authorized representative.
- d) The effective date of transfer shall be no later than 15 calendar days after the date of the Participant Agreement − Person-Centered Plan of Care and service shall be initiated by the receiving provider without service interruption.
- e) If any delay in any of the time frames established in this Section is caused by the documented action or inaction of the participant/authorized representative, time frames shall be extended by the number of calendar days of delay.
(Source: Amended at 48 Ill. Reg. 11053, effective July 16, 2024)