Section 4530.80 Examination

Section 4530.80  Examination

a)         The

Director or his or her designee may examine any applicant for registration or

any registrant upon receipt of information that the applicant or registrant may

be in violation of this Part, or any applicable provision of the Code, when he

or she receives a complaint or when the applicant has a history of violations

of the Code.

b)         Any

independent review organization being examined shall provide to the Director or

his or her designee convenient and free access, during reasonable hours at the

organization's offices, to all books, records, documents and other papers

relating to the independent review organization's business affairs.  The

Director or designee shall not have access to beneficiary medical records

protected under Sections 8-2101 through 8-2105 of the Code of Civil Procedure

titled "Medical Studies" [735 ILCS 5/8-2101 through 8-2105].

c)         The

Director or designee may administer oaths and thereafter examine any individual

about the business of the independent review organization.

d)         The

expenses of examination under this Section shall be assessed against the

independent review organization being examined in accordance with Section

408(3) of the Code.

e)         The

examiner designated by the Director shall make a written report if he or she

alleges a violation of this Part, any applicable provisions of the Code or any

other applicable Part of Title 50 of the Illinois Administrative Code.  The

report shall be verified by the examiner. The report must be made to the

Director within 45 days after the conclusion of the examination.

f)         The

Director shall deliver a duplicate of the report to the independent review

organization being examined using the address specified in the Department's

records.  In that event, the IRO may request a hearing before the Director or

designee within 30 days after receipt of the duplicate examination report

made to the

Director within 45 days after the conclusion of the examination.

f)         The

Director shall deliver a duplicate of the report to the independent review

organization being examined using the address specified in the Department's

records.  In that event, the IRO may request a hearing before the Director or

designee within 30 days after receipt of the duplicate examination report.  The

request shall be in writing and include the IRO's objections to the report.  The

hearing shall be conducted in accordance with Sections 402 and 403 of the Code

and 50 Ill. Adm. Code 2402.  The IRO's right to hearing is waived if the

delivery of the report is refused, or the IRO does not timely request a

hearing.  After hearing, or upon expiration of the time period during which an IRO

may request a hearing and the IRO has not done so, the Director, upon finding

noncompliance with the laws of this State or previous Order of the Director,

may require the IRO to take corrective action. Any such Order shall be issued

within 90 days after the report is filed, or, if there is a hearing, within 90

days after the conclusion of the hearing.  The Order shall be a final

administrative decision of the Department subject to review under the

Administrative Review Law [735 ILCS 5/Art. III].