Department of Intellectual and Developmental Disabilities, DIDD Providers and LEIE

1. 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

2. Presentation Notes • 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

3. What is the List of Excluded Individuals and Entities? “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

4. 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

5. 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

6. 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

7. What is new starting this month? 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

8. Who has to be checked? 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

9. Reporting Tool • 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

10. Template Review • 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

11. Template Review • 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

12. Template Review • 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

13. Template Review • File Type • The password remains with the file. It did not change. May 7 and May 8 Provider Webinars

14. Template Review • 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

15. Template Review • Saving – Open Office • It will make you reenter the password May 7 and May 8 Provider Webinars

16. Template Review • Saving – Open Office • Keep Current Format May 7 and May 8 Provider Webinars

17. Email • 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

18. Email • 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

19. Proposed Long Term Process • 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

20. Methods to Perform the Check • 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

21. Methods to Perform the Check • Result: Initial Hit Example: Using the name: Anderson – multiple results May 7 and May 8 Provider Webinars

22. Methods to Perform the Check • 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

23. Methods to Perform the Check • 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

24. Methods to Perform the Check • 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

25. Regional Office Contacts • West Region Providers: Monda Qualls monda.qualls@tn.gov731-421-5175 • Middle Region Providers: Crissonya Phillips crissonya.phillips@tn.gov615-231-5092 • East Region Providers: Janet Kinley janet.kinley@tn.gov423-787-6495 May 7 and May 8 Provider Webinars

26. Follow Up • 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

27. Questions May 7 and May 8 Provider Webinars

28. Regional Office Contacts • 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 monda.qualls@tn.gov731-421-5175 Middle Region Providers: Crissonya Phillips crissonya.phillips@tn.gov615-231-5092 East Region Providers: Janet Kinley janet.kinley@tn.gov423-787-6495 • 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