Department’s Responsibility. The Department will provide the CHC-MCO with prompt notice via electronic transmission oraccess to Medicheck listings or upon request if a Network Provider is subsequently suspended or terminated from participation in the MA or Medicare Programs. Upon notification from the Department, the CHC-MCO must immediately act to terminate the Provider from its Network. A CHC-MCO’s termination must coincide with the MA effective date of termination for loss of licensures and criminal convictions. The CHC-MCO is required to check the Social Security Administration’s Death Master File (SSADMF), and National Plan and Provider Enumeration System (NPPES) at the time of initial enrollment and re-enrollment as well as providers, owners, agents, and managing employees against the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) List of Excluded Individuals and Entities (LEIE), the Excluded Party List System (EPLS) on the System for Award Management (XXX), and the PA Medicheck list on a monthly basis as required in 42 CFR. §455.436.
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Samples: Community Healthchoices Agreement, 2023 Community Healthchoices Agreement, 2022 Community Healthchoices Agreement