Healthcare Providers participating in the Louisiana Medicaid Program are prohibited from contracting with individuals or entities that have been excluded from the program.
It’s the responsibility of providers to ensure that current and potential employees, contractors and other agents and affiliates have not been excluded from participation in Medicaid or Medicare Programs, by Louisiana Medicaid or by the Department of Health and Human Services’ of the Office of Inspector General.
Any provider who contracts or employs excluded individuals or entities will incur a penalty of $10,000 for every item or service provided by the entity or individual.
Providers have been previously instructed to check these 2 websites to confirm whether employees, and subcontractors performing services paid for with Medicaid or Medicare funds have exclusions imposed on them at the federal level.
- The Department of Health and Human Services’ Office of Inspector General website: http://exclusions.oig.hhs/search.aspx
- The System for Award Management (SAM) website: https://sam.gov/portal/SAM#1. This website is only for entities and should not be used to search employees.
Effective immediately, employers should conduct searches of individuals and entities at https://adverseactions.dhh.la.gov, which is the Louisiana Department of Health and Hospitals Adverse Actions website. Checks should be conducted upon hire and monthly thereafter.
The website is user friendly and allows providers to:
- Conduct single or multiple searches
- Export databases in excel format
- Print search results and maintain the records as evidence that checks were done on employees and/or subcontractors.
Guidelines for using the website
As provided in the Provider Enrollment Agreements, the Medical Assistance Program Integrity Law (MAPIL) cited as Louisiana Revised Statute 46:437, referenced in the Louisiana Administrative Code (LAC) Title 50 and the Code of Federal Regulations 42 CFR § 455.436, providers should use the website as follows:
- Providers should check all names, including first, middle, maiden, married or hyphenated names and aliases for all owners, employees and contractors.
- If the name of an individual or entity appears on these websites, this person or entity is considered excluded.
- Excluded individuals or entities are barred from working with Medicare and the Louisiana Medicaid Program in any capacity.
- If the provider learns of the exclusion 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, with the following information:
- Name of the excluded individual or entity and
- Status of the individual or entity (applicant or employee/contractor).
If the individual or entity is an employee or contractor, the provider should also include the following information:
- Beginning and ending dates of the individual’s or entity’s employment or contract with the agency,
- Documentation of termination of employment or contract, and
- Type of service(s) provided by the excluded individual or entity.
This information should be sent to the following address:
Department of Health and Hospitals
P.O. Box 91030
Baton Rouge, LA 70821-9030
- Providers should still use the Nurse Aide Registry/Direct Service Worker Registry at labenfa.com, for checking Certified Nursing Assistants (CNA) and Direct Service Workers (DSW) upon hire and every six months thereafter.
- There is no automatic reinstatement at either the federal or state level and excluded individuals must request reinstatement after the minimum excluded period has been served.