Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 104 - PRACTICE IN ADMINISTRATIVE HEARINGS › Subpart C - MEDICAL VENDOR AND ALTERNATE PAYEE HEARINGS › Section 104.221 - Issues at Hearings

Current through Register Vol. 48, No. 28, July 12, 2024
a) The sole
				issue at a hearing in which the basis for denial of an application pursuant to
				89 Ill. Adm. Code
				140.14(d)
				is that the vendor does not have a necessary license, certificate or
				authorization shall be whether the vendor has such a license, certificate or
				authorization.
b) The sole issue at
				a hearing in which the basis of the denial of an application is as set forth in
				89 Ill. Adm. Code
				140.14(b)
				shall be whether the vendor has demonstrated, according to the factors listed
				in that Section, in light of the prior activities, that he or she should be
				admitted to the Medical Assistance Program.
c) Effective July 1, 2012, the only issues at
				a hearing in which the basis of the denial of an application is as set forth
				in:
1) 89 Ill. Adm. Code
				140.14(e)(1)
				 shall be whether the applicant or any person
				with management responsibility for the applicant, an officer or member of the
				board of directors of the applicant, an entity owning (directly or indirectly)
				5% or more of the shares of stock or other evidences of ownership in a
				corporate vendor applicant, an owner of a sole proprietorship applicant, a
				partner in a partnership applicant, or a technical or other advisor to the
				applicant has a debt owed to the Department and/or whether payment arrangements
				acceptable to the Department have been made by the applicant.
2) 89 Ill. Adm. Code
				140.14(e)(2)
				 shall be whether the applicant or any person
				with management responsibility for the applicant, an officer or member of the
				board of directors of the applicant, an entity owning (directly or indirectly)
				5% or more of the shares of stock or other evidences of ownership in a
				corporate vendor applicant, an owner of a sole proprietorship applicant, a
				partner in a partnership vendor applicant, or a technical or other advisor to
				the applicant was a person with management responsibility, an officer or member
				of the board of directors of an applicant, an entity owning (directly or
				indirectly) 5% or more of the shares of stock or other evidences of ownership
				in a corporate vendor, an owner of a sole proprietorship, a partner in a
				partnership vendor, or a technical or other advisor to a vendor during the
				period of time when the conduct of that vendor resulted in a debt owed to the
				Department and/or whether payment arrangements acceptable to the Department
				have been made by that vendor.
3)
				89 Ill. Adm. Code
				140.14(e)(3)
				 shall be whether the allegation of the use,
				transfer or lease of assets of any kind to the applicant from a current or
				prior vendor who has a debt owed to the Department is credible, whether payment
				arrangements acceptable to the Department have been made by that vendor or the
				vendor's alternate payee, and/or whether the applicant knows or should have
				known of the debt.
4) 89 Ill. Adm.
				Code
				140.14(e)(4)
				 shall be whether the allegation of a
				transfer of management responsibilities, or direct or indirect ownership, to an
				applicant from a current or prior vendor who has a debt owed to the Department
				is credible, whether payment arrangements acceptable to the Department have
				been made by that vendor or the vendor's alternate payee, and/or whether the
				applicant knows or should have known of the debt.
5) 89 Ill. Adm. Code
				140.14(e)(5)
				 shall be whether the allegation of the use,
				transfer or lease of assets of any kind to an applicant who is a spouse, child,
				brother, sister, parent, grandparent, grandchild, uncle, aunt, niece, nephew,
				cousin, relative by marriage, or relative of a current or prior vendor who has
				a debt owed to the Department is credible and/or whether payment arrangements
				acceptable to the Department have been made.
6) 89 Ill. Adm. Code
				140.14(e)(6)
				 shall be whether the allegation that the
				applicant's previous affiliations with a provider of medical services that has
				an uncollected debt, a provider that has been or is subject to a payment
				suspension under a federal health care program, or a provider that has been
				previously excluded from participation in the Medical Assistance Program poses
				a risk of fraud, waste or abuse to the Department is credible.