As a condition of participation in the Louisiana Medicaid Program,providers are responsible for ensuring current and potential employees,contractors and other agents and affiliates have not been excluded from participation in the Medicaid, or Medicare Program by Louisiana Medicaid, or the Department of Health and Human Services’ Office of Inspector General. Providers who employ or contract with excluded individuals or entities may be subject to penalties of $10,000 for each item or services the excluded individual or entity furnished.
Providers have been instructed to check:
- U.S. Department of Health and Human Services’ Office of Inspector General Exclusion List
- System for Award Management (SAM) Exclusion List
- Louisiana Department of Health and Hospitals Adverse Action / Direct Service Worker Registry List
- Nurse Aide Registry
for any exclusion imposed at the federal or State level upon hire and monthly thereafter for employees and/or subcontractors that perform services that are compensated with Medicaid/Medicare funds. Providers that employee Certified Nursing Assistants (CNA) and Direct Service Workers (DSW) are required to check these registries upon hire and every six months thereafter.
If an individual’s or entity’s name appears on the exclusion list,this person or entity is considered excluded and is barred from working with Medicare and/or the Louisiana Medicaid Program in any capacity. If the exclusion is learned prior to employment the provider should not employ the person or entity. If the provider learns of the exclusion after hiring the provider must notify the Department of Health and Hospitals within ten working days of discovering the exclusion.
These findings should be reported to:
Department of Health and Hospitals
P.O. Box 91030
Baton Rouge, LA 70821-9030
These requirements are identified in the Provider Enrollment Agreements, the Medical Assistance Program Integrity Law (MAPIL) cited as Louisiana Revised Statute46:437, referenced in the Louisiana Administrative Code (LAC) Title 50 and the Code of Federal Regulations 42 CFR § 455.436.