Providers’ Obligation to Screen Employees and Contractors for Excluded Persons
The Centers for Medicare and Medicaid Services issued State Medicaid Director Letter #09-001 dated January 16, 2009 regarding excluded persons. The letter advises States of their obligation to direct providers to screen their employees and contractors for excluded persons. In particular, the letter states, in part:
Policy Clarification: States Should Advise Medicaid Providers to Screen for Exclusions
To further protect against payments for items and services furnished or ordered by excluded parties, States should advise all current providers and providers applying to participate in the Medicaid program to take the following steps to determine whether their employees and contractors are excluded individuals or entities:
States should advise providers of their obligation to screen all employees and contractors to determine whether any of them have been excluded. States should communicate this obligation to providers upon enrollment and reenrollment.
States should explicitly require providers to agree to comply with this obligation as a condition of enrollment.
States should inform providers that they can search the HHS-OIG website by the names of any individual or entity.
States should require providers to search the HHS-OIG website monthly to capture exclusions and reinstatements that have occurred since the last search.
States should require that providers immediately report to them any exclusion information discovered.
The letter can be viewed in its entirety at:
https://www.cms.gov/SMDL/downloads/SMD011609.pdf
The Missouri Medicaid Audit and Compliance Unit does consider compliance with the steps outlined in the letter and summarized above as an integral part of a providers’ provision of service delivery to MO HealthNet program participants. Compliance with these requirements may be subject to review by the Missouri Medicaid Audit and Compliance Unit.