Program Exceeds Combined Fiscal year Maximum or Bedhold Maximum

Paid bills have exceeded a maximum for the program and individual.

Fiscal year maximum

When paid bills reach the state fiscal year maximum for the program for the individual, no further bills for that program for that individual will be paid for services through the end of June. For example, for day programs, the Division pays for the entire fiscal year in the first 1,100 hours billed.

Bedhold maximum

For CILA (Program 60D), paid bills reach the 60 consecutive bedhold days limit, no further bedhold days will be paid.

For other residential programs, when paid bills reach the 60 cumulative bedhold days per state fiscal year limit, no further bedhold days will be paid without an approved Bedhold Extension Request.

Submit a IL462-2027 - Bed Hold Extension Request Form (pdf) to Network staff.  Also located in the Provider Waiver Manual Appendices

Return to reject code list page