Professional LLCs Must Register with IDFPR

FOR IMMEDIATE RELEASE January 13, 2011
Professional LLCs Must Register with State
Registration of health care groups will expand patient protections
SPRINGFIELD – To better protect consumers faced with problems in dealing with their health care providers, Limited Liability Companies (LLCs) formed by licensed health care and other professionals will now be required to register with the Illinois Department of Financial and Professional Regulation, Division of Professional Regulation (IDFPR).  Medical and Professional Service Corporations have long been required to register with IDFPR, and this law expands that requirement to cover LLCs established by licensed professions, including doctors and dentists.  The purpose of registration is to provide information to consumers as well as assist the Department in its enforcement activities. Registration provides basic information about the LLC and most importantly discloses the licensee(s) responsible for the operation of the LLC.  Patients dealing with the LLC for billing, scheduling and other business related activities can seek assistance from IDFPR if they have problems not directly related to the work of a licensed professional.  This registration requirement establishes a new level of regulatory oversight to make sure health care consumers receive the same protection regardless of how their provider’s practice is structured.  Applications for registration of limited liability companies are now available. The application packets contain detailed instructions and other information which can be viewed and printed at www.idfpr.com.  The initial registration fee is $50 and the annual renewal fee is $40.  Applications are required to be submitted by existing limited liability companies as well as new entities just forming with the Illinois Secretary of State.  All LLCs are expected to be licensed within 90 days and the department will begin enforcement for failure to be licensed on that date.

Deadline Missed for TRICARE LCPC Independent Practice Rule

Deadline Missed for TRICARE LMHC Independent Practice Rule
Washington, DC – June 24, 2011 – The National Defense Authorization Act for fiscal year 2011, signed in January 2011, directed the Department of Defense (DoD) to adopt regulations allowing licensed mental health counselors (LMHCs) to practice independently under the TRICARE program. The Act gave DoD until June 20th of this week to issue rules implementing the requirement, but DoD has now missed the deadline, making it impossible to implement the directive. Presently, we are hearing uncertain estimates of when the rule may be released, ranging from six to 18 months.

AMHCA has led LMHCs in encouraging the DoD to adopt regulations implementing the rule, which will make it easier for beneficiaries to gain access to needed care. However, we have also called on DoD to adopt more inclusive regulations that will recognize a wider array of qualified LMHCs than a recently adopted standard set in a separate VA administrative procedure.

AMHCA will continue to work with the DoD to ensure the regulations are more inclusive than the VA LMHC eligibility standard, and AMHCA is closely monitoring the agency's activity on this matter. For more information or if you have questions, contact James Finley, AMHCA's director of public policy, at jfinley@amhca.org.

Illinois Human services Budget

Dear Illinois Partners:

We have some important updates from the meeting this morning of the Human Services Commission.  Jerry Stermer from Governor Quinn's office assured us that the Governor intends to sign the FY12 budget that was passed by the Illinois General Assembly (HB3717) by June 30th.  In addition, Secretary Saddler of the Department of Human Services confirmed that new contracts will be sent to providers sometime next week.  Thanks to the advocacy of Illinois Partners, these contracts will be temporary, covering 4 months, to allow time for continued discussion and negotiation around any additional changes DHS intends to make for the remainder of FY12.  It is critical to note that the FY12 DHS budget has been reduced by $668 million from FY11, a 17.2% total reduction.  To review the reductions by specific line items, take a look at the information on our website.  Secretary Saddler stated this morning that the DHS contracts issued next week will be issued at 31.67% of the full FY12 appropriation.  There is an understanding that there is a disconnect between the statutory requirements facing state agencies and the corresponding appropriations levels passed by the General Assembly.  While there is hope for revenue to come in at a higher level than what the FY12 budget is based on, there is real uncertainty.  The Human Services Commission requested follow-up reports from the various state agencies once the FY12 budget has been signed by the Governor and decisions about implementing the FY12 budget have been made.

Please stay tuned, as we learn more details about the FY12 budget, we will contact you.  Thank you again for all that you do!    Judith Judith Gethner, Director Illinois Partners for Human Service Quality Services. Adequate Funding. Measurable Results. 312-906-2364 (p); 847-863-0040 (c) www.illinoispartners.org

Medicaid Rules 132 new definition of Medically Necessary

Medical Necessity or Medically Necessary − An LPHA has determined through assessment that a client has a diagnosis of mental illness or serious emotional disorder as defined in the ICD-9-CM or DSM-IV that has resulted in a significant impairment in the client's level of functioning in at least one major life functional area and needs one or more mental health services that are identified in the Mental Health Assessment and ITP to stabilize the client's functioning, or to restore or rehabilitate the client to a maximum level of life functioning.  For clients under the age of 21, medical necessity or medically necessary may additionally mean that the client has more than one documented criteria of a mental illness or serious emotional disorder as listed in the DSM-IV that is likely to impact the client's level of role functioning across critical life areas and needs a Medicaid reimbursable Part 132 mental health service recommended by the completion of an approved Healthy Kids screen by a physician or the completion of a Mental Health Assessment and included in an ITP that could not have been omitted without adversely affecting the client's level of functioning.
http://www.ilga.gov/commission/jcar/admincode/059/059001320A00250R.html

IDFPR New Rules on for individuals with a criminal conviction to request a non-binding, advisory opinion from the Department on the impact their criminal conviction might have with respect to an application for licensure

http://ilsos.net/departments/index/register/register_volume35_issue21.pdf

Summary and Purpose of Rules: Public Act 96-852 included a provision amending the Civil Administrative Code to direct the Department of Financial and Professional Regulation to establish a process for individuals with a criminal conviction to request a non-binding, advisory opinion from the Department on the impact their criminal conviction might have with respect to an application for licensure; this adopted rulemaking implements that provision. It provides a method for individuals with criminal convictions to ask the Department what impact, if any, their criminal conviction will or might have with respect to an application for licensure. It further provides a method for the Division of Professional Regulation to respond to those inquiries.

16)

Section 1130.20 Request for Non-Binding, Advisory Opinion

a) An individual shall file a request for a non-binding, advisory opinion on forms provided by the Department. The request shall include:

1) A copy of all convictions for which the individual seeks a non-binding, advisory opinion from the Department;

2) Copies of any certificate of relief from disabilities that the individual may have received or obtained;

3) A detailed nature of the offense;

4) Any statements of mitigation;

5) Any prior conviction of or entry of a plea of guilty or nolo contendere to any crime that is a felony or misdemeanor under the laws of the United States or any state or territory thereof or a misdemeanor of which an essential element is dishonesty or that is directly related to the practice of the profession;

6) Any licenses held or prior applications filed with the Division;

7) The profession for which the individual intends to seek licensure (if the individual intends to seek licensure in more than one profession and is seeking a non-binding, advisory opinion on more than one profession, the individual shall complete a separate request for each profession for which the individual is seeking a non-binding, advisory opinion);

8) If applicable, verification from any state in which an individual is or has been licensed stating:

A) The time during which the individual was licensed in that state, including the date of the original issuance of the license; and 
B) Whether the file on the individual contains any record of disciplinary actions taken or pending.

b) When the accuracy of any submitted documentation or the relevance or sufficiency of the information submitted by the individual is questioned by the Department or the Board because of lack of information, discrepancies or conflicts in information given, or a need for clarification, the individual seeking licensure may be requested to provide further information as may be necessary.

c) In determining whether an individual's criminal record, as disclosed in the request, is considered a bar to the future licensure of the individual, the Department may consider the following factors or any other factors deemed relevant by the Department:

1) Whether there is a direct relationship between one or more of the previous criminal offenses and the specific license to be sought;

2) Whether the issuance of the license would involve an unreasonable risk to property or to the safety or welfare of specific individuals or the general public;

3) The specific duties and responsibilities necessarily related to the license being sought;

4) The bearing, if any, the criminal offenses will have on the applicant's fitness or ability to perform one or more of the duties and responsibilities of a licensee;

5) The time that has elapsed since the occurrence of the offenses;

6) The age of the individual at the time of occurrence of the criminal offenses;

7) The seriousness of the offenses; and
8) Any information produced by the individual or produced on his or her behalf in regard to his or her rehabilitation and good conduct, including a certificate of relief from disabilities issued to the individual, which shall create a presumption of rehabilitation in regard to the offenses specified in the certificate.

Section 1130.30 Board Review

a) At any time during the review and determination of a request for a non-binding, advisory opinion as to whether the criminal record of an individual as disclosed in the request would bar the individual from the licensure or certification to be sought, the Department may, but shall not be required to, seek the advice and/or recommendation of the Board established for the profession for which the individual seeks licensure or certification.

b) Any recommendation taken by the Board shall be taken at a meeting held in accordance with the Open Meetings Act [5 ILCS 120]. In exigent circumstances, as determined in the sole discretion of the Department, the Department may contact an individual Board member for advice concerning any individual's

request for a non-binding, advisory opinion.