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Department of Intellectual and Developmental Disabilities, DIDD Providers and LEIE. Reporting Requirements for the List Of Excluded Individuals and Entities (LEIE). Presentation Notes. You should be able to hear the presenter through your speakers or headphones

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Department of intellectual and developmental disabilities didd providers and leie

Department of Intellectual and Developmental Disabilities, DIDD Providers and LEIE

Reporting Requirements for the List Of Excluded Individuals and Entities (LEIE)

May 7 and May 8 LEIE Provider Webinars


Presentation notes
Presentation Notes DIDD Providers and LEIE

  • You should be able to hear the presenter through your speakers or headphones

  • Questions should be entered in the Chat Box on the left of the screen and will be addressed at the end.

  • This presentation will be posted on the DIDD Website shortly

  • We will post additional Instructions and Frequently Asked Questions (FAQ’s) on the website as well

May 7 and May 8 Provider Webinars


What is the list of excluded individuals and entities
What is the List of Excluded Individuals and Entities? DIDD Providers and LEIE

“OIG’s List of Excluded Individuals/Entities (LEIE) provides information to the health care industry, patients and the public regarding individuals and entities currently excluded from participation in Medicare, Medicaid and all other Federal health care programs. Individuals and entities who have been reinstated are removed from the LEIE.”

http://oig.hhs.gov/exclusions/index.asp

May 7 and May 8 Provider Webinars


What are the current requirements for providers concerning leie
What are the current requirements for providers concerning LEIE?

Existing Requirement for providers to check their employees and subcontractors.

Provider Agreement in A.5. State and Federal Compliance (d) Provider Screening (ii):

“The Provider and its subcontractors shall collect the disclosure of health care-related criminal conviction information as required by 42 CFR § 455.106 and establish policies and procedures to ensure that applicable criminal convictions are reported timely to DIDD. The Provider shall screen its employees and subcontractors initially and on an ongoing monthly basis to determine whether any of them has been terminated, debarred or excluded from participation in Medicare, Medicaid, SCHIP, or any Federal health care programs (as defined in Section 1128B (f) of the Social Security Act) and not employ or contract with an individual or entity that has been excluded. The provider shall immediately report to DIDD and the Program Integrity Unit of TennCare any exclusion information that the provider discovers.”

May 7 and May 8 Provider Webinars


What are the current requirements for providers concerning leie1
What are the current requirements for providers concerning LEIE?

Existing Requirement for providers to check their employees and subcontractors.

Provider Manual in section 5.2.g.3 states,

“The provider must screen its employees and subcontractors initially and on an ongoing monthly basis to determine whether any of them has been terminated, debarred or excluded from participation in the Medicare, Medicaid, SCHIP, or any federal health care program (as defined in Section 1128B (f) of the Social Security Act). And not employ or contract with an individual or entity that has been excluded.”

May 7 and May 8 Provider Webinars


What are the current requirements for providers concerning leie2
What are the current requirements for providers concerning LEIE?

Existing Requirement that proof of performing this check must be maintained.

In the Provider Manual in section: 10.13.a. Employee Records. The following documentation must be maintained in the personnel records for each individual employed:

“5. Results obtained from checking the DOH’s Tennessee Elderly and Vulnerable Abuse Registry, the Tennessee Felony Offender Information List (FOIL), the Sexual Offender Registry, and the Office of Inspector General’s List of Excluded Individuals/Entities.”

May 7 and May 8 Provider Webinars


What is new starting this month
What is new starting this month? LEIE?

Results are to be reported to DIDD by the 15th (or first business day after) of each month

Even if there aren’t any matches.

May 7 and May 8 Provider Webinars


Who has to be checked
Who has to be checked? LEIE?

Providers are hereby directed to screen their employees and contractors in accordance with the instructions found on the OIG website cited above. Contractors that must be screened are those paid by the provider using Medicaid funds.  Services purchased by, or for, persons supported using their personal funds are excluded from this requirement.

  • Provider employees prior to hiring and then monthly

  • Subcontractors prior to contract execution and then monthly

    • Company and employees

May 7 and May 8 Provider Webinars


Reporting tool
Reporting Tool LEIE?

  • Supplied in an Excel 97-2003 Template format

    • Can use Microsoft Excel 2003 or newer

      • Recommend the “Microsoft Office Compatibility Pack for Word, Excel, and PowerPoint File Formats” at http://www.microsoft.com/en-us/download/details.aspx?id=3

    • Apache Open Office Calc - free

      • There are some special instructions

        Do not try to change the spreadsheets

        Just fill in the data

May 7 and May 8 Provider Webinars


Template review
Template Review LEIE?

  • You received an Excel Template

  • Password: LEIEDIDD It is case sensitive.

  • Review of Each Tab

    • Exclusions Details Tab

      • This is where real data starting this month will be placed

      • Do not erase the data from the previous month.

      • Add new data to the bottom

      • You will have at least one entry every month

      • Don’t try to change headers or other fields

May 7 and May 8 Provider Webinars


Template review1
Template Review LEIE?

  • Exclusion Authorities Tab

    • Gives detailed information on the reasons for exclusions.

    • Clicking on a live link takes you to more information

  • Requirements and LD’s Tab

    • States the federal requirement concerning the reporting of findings of all employees and contractors.

    • Specifies the liquid damages if this requirement is not met.

May 7 and May 8 Provider Webinars


Template review2
Template Review LEIE?

  • Examples Tab

  • Formats and Guidance

    • No Match

    • Exclusions

  • Saving – The first time it will make you Name it and place it somewhere. This will only happen the first time. After that it will be a normal save.

  • Excel Example: File Naming Convention:

    Include your Provider Number!

    DIDD LEIE Report Spreadsheet - #####

    Where ##### is your Provider number

    Example: DIDD LEIE Report Spreadsheet – 99AAA

    It will automatically add the file extension

May 7 and May 8 Provider Webinars


Template review3
Template Review LEIE?

  • File Type

  • The password remains with the file. It did not change.

May 7 and May 8 Provider Webinars


Template review4
Template Review LEIE?

  • Saving – The first time it will make you Name it and place it somewhere. Open Office Example

  • File Naming Convention:

    Include your Provider Number!

    DIDD LEIE Report Spreadsheet - #####

    Where ##### is your Provider number

    Example: DIDD LEIE Report Spreadsheet – 99AAA

    • File Type

May 7 and May 8 Provider Webinars


Template review5
Template Review LEIE?

  • Saving – Open Office

    • It will make you reenter the password

May 7 and May 8 Provider Webinars


Template review6
Template Review LEIE?

  • Saving – Open Office

    • Keep Current Format

May 7 and May 8 Provider Webinars


Email
Email LEIE?

  • Don’t use a secure email provider like FortiMail Registered Envelope Service or Cicso Registered Email Service

  • Send email through your normal email provider. The file is password protected. It meets all required security standards.

May 7 and May 8 Provider Webinars


Email1
Email LEIE?

  • Email Subject: LEIE 88A66YYYYMM

    Where 88A66 is your provider number and YYYYMM is the Year and Month just like on the latest entry on the sheet.

    Please try to be consistent, The RO Staff would appreciate it

May 7 and May 8 Provider Webinars


Proposed long term process
Proposed Long Term Process LEIE?

  • Provider logs into a DIDD website specifically to report LEIE information like they do for PCP

    • Logins to be maintained by DIDD similar to PCP logins – one per provider.

  • Provider answers one of two questions (verbiage to be finalized)

    • “All employees, subcontractors and subcontractor personnel have been screened and there are no exclusions.”

      • Attach Document button allows the person to attach the Excel template spreadsheet.

      • Clicking YES records the date, time and log in (provider)

      • The file is uploaded securely as the connection is through an SSL socket.

        • Will no longer need to be password protected.

    • “All employees, subcontractors and subcontractor personnel have been screened and there are exclusions. The file is attached”

      • Attach Document button allows the person to attach the Excel template spreadsheet.

      • Clicking YES records the date, time and log in (provider)

      • The file is uploaded securely as the connection is through an SSL socket.

        • Will no longer need to be password protected.

  • Regional Office and Central Office personnel have a report available to show monthly provider compliance.

May 7 and May 8 Provider Webinars


Methods to perform the check
Methods to Perform the Check LEIE?

  • As this is already a requirement this is merely a refresher

  • Directly from the website - Demonstration

    • Result: No Match

      • Record the search - Print or Screen Shot

May 7 and May 8 Provider Webinars


Methods to perform the check1
Methods to Perform the Check LEIE?

  • Result: Initial Hit

    Example: Using the name: Anderson – multiple results

May 7 and May 8 Provider Webinars


Methods to perform the check2
Methods to Perform the Check LEIE?

  • Next Step: Verify

    • Enter SSN or EIN and you’ll get one of two results.

    • No Match – do not include this on the spreadsheet!

      • Record the result of the search - Print or Screen Shot

May 7 and May 8 Provider Webinars


Methods to perform the check3
Methods to Perform the Check LEIE?

  • Next Step: Verify

    • Enter SSN or EIN and you’ll get one of two results.

    • Match – report this on the spreadsheet!

      • Record the result of the search - Print or Screen Shot

  • If it is a true exclusion – that individual or entity can no longer receive any Medicaid funds directly or indirectly.

May 7 and May 8 Provider Webinars


Methods to perform the check4
Methods to Perform the Check LEIE?

  • As this is already a requirement this is merely a refresher

  • Download the file and develop an application

    • Full File Download – updated each month

    • Monthly Updates

    • Application can be built to compare your employee, subcontractor and subcontractor employees on file against this downloaded data set.

    • Any ‘Hits’ need to be verified using the Website as the downloaded file does not have Social Security Numbers.

      • Verify – only report Excluded on the spreadsheet

      • Record the result of the search either way

        • Print or Screen Shot

      • If it is a true exclusion – that individual or entity can no longer receive any Medicaid funds directly or indirectly.

      • Demonstration

May 7 and May 8 Provider Webinars


Regional office contacts
Regional Office Contacts LEIE?

May 7 and May 8 Provider Webinars


Follow up
Follow Up LEIE?

  • This presentation will be on the DIDD Website

  • We will post additional Instructions and Frequently Asked Questions (FAQ’s) to the website

  • We will keep everyone informed of the Long Term Solution

  • Use the website – Quick Tips Page and the video are good sources of information

  • Remember

    • Every provider must send one in by the 15th (or first business day after) of each month

    • Only include No Match or verified Exclusions

    • One per provider number per month – do not erase previous monthly entries

May 7 and May 8 Provider Webinars


Questions
Questions LEIE?

May 7 and May 8 Provider Webinars


Regional office contacts1
Regional Office Contacts LEIE?

  • Please send an email that you participated to one of these three people with your Provider Name and Provider Number.

    West Region Providers: Monda Qualls [email protected]

    Middle Region Providers: Crissonya Phillips [email protected]

    East Region Providers: Janet Kinley [email protected]

  • DIDD LEIE Template and other documents:

  • http://tn.gov/didd/provider_agencies/OIG/index.shtml

  • OIG Website:

  • http://oig.hhs.gov/exclusions/index.asp

  • Password: LEIEDIDD

  • Every provider must send one in by the 15th (or first business day after) of each month

  • Only include No Match or verified Exclusions

  • One per provider number per month – do not erase previous monthly entries

May 7 and May 8 Provider Webinars


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