Section 4530.60 Registration of Independent Review Organizations

Section 4530.60  Registration of Independent Review

Organizations

a)         On or

after July 1, 2010, an independent review organization may not conduct external

reviews for persons subject to Section 15 of the Act unless the independent

review organization has registered with the Director. An application for

registration shall be in the format set forth in Appendix C and must be signed

by an officer or director of the independent review organization. Initial

registration applications shall be deemed approved unless the Director finds an

application to be noncompliant with either the standards set forth in Section

55 of the Act or this Part.

b)         An

independent review organization must register with the Director every 2 years.

A fee of $1,000 must be submitted with each application or renewal. If the

Director determines that there are no acceptable nationally recognized private

accrediting entities providing independent review organization accreditation,

he or she may then approve independent review organizations that are not

accredited by a nationally recognized private accrediting entity, in which case

the fee for each application or renewal shall be $1,500.

c)         Any

material changes in the information filed pursuant to this Part shall be filed

with the Director within 30 days after the change. Loss of accreditation status

will require re-registration and payment of the appropriate fee pursuant to

subsection (b).

d)         Renewals and Appeals

1)         A

registered independent review organization may continue to operate, if a renewal

application as specified in Appendix D and fee have been filed 30 days prior to

the renewal date, until the renewal is denied or issued by the Director.

2)         If

the renewal application and fee are not received prior to the renewal date, the

registration will automatically expire and the independent review organization

must re-register and pay a fee pursuant to subsection (b)

f a renewal

application as specified in Appendix D and fee have been filed 30 days prior to

the renewal date, until the renewal is denied or issued by the Director.

2)         If

the renewal application and fee are not received prior to the renewal date, the

registration will automatically expire and the independent review organization

must re-register and pay a fee pursuant to subsection (b).

3)         If an

application for registration or renewal is denied under this Part, the

applicant may appeal the denial by requesting a hearing under the terms of

Article 10 of the Illinois Administrative Procedure Act [5 ILCS 100/Art. 10]

and 50 Ill. Adm. Code 2402. A petition for hearing must be postmarked no later

than 30 days from the date of initial denial. A hearing shall be scheduled

within 45 days after the petition is filed with the Director. A decision by the

Director shall be rendered within 60 days after the close of the hearing.