Specifications include, but are not limited to: DSS will share an export of provider data via SFTP with the successful offeror. Refer to Exhibit 3 for file layouts. DSS will also share assigned risk levels based on taxonomy codes to assist the offeror. The successful offeror shall utilize this data to screen providers, the entities or person(s) with an ownership or control interest in the provider, and the agent(s) or managing employee(s) of the provider at the time of enrollment, re-enrollment, revalidation, and at the request of DSS. The offeror will complete and adhere to the screening items. The offeror should populate Attachment B – Cost Proposal Worksheet 3.1 and provide additional responses as appropriate to include: 3.1.1 Confirmation of the ability to use the file layout and proposed SFTP mechanism; 3.1.2 A listing of what screening activities will be completed, with a response to all the items below: 3.1.2.1 Confirm the identity of providers to ensure they may be considered for enrollment. 3.1.2.2 Use National Plan & Provider Enumeration System (NPPES) data to verify the type and status of NPI. 3.1.2.3 Check the System for Award Management (SAM) to determine exclusion status. 3.1.2.4 Check the Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) to determine exclusion status. 3.1.2.5 Utilize the Social Security Administration Death Master File (DMF) to verify social security numbers and dates of death. 3.1.2.6 Utilize DEX to its fullest extent to identify individuals and current or historical issues including terminations taken by other State Medicaid Agencies or Medicare. 3.1.2.7 Verify the servicing location address, which must be a street address, exists (optional). 3.1.2.8 Verify provider licensure and certification data including license/certification number, issuance date, expiration date, state of issuance, and current good standing or limitations for the enrollment type requested, including those in more than one state based on servicing addresses. 3.1.2.9 Check Medicare Provider Enrollment, Chain, and Ownership System (PECOS) to determine provider participation status and if provider has been screened in most recent 12-month period the corresponding fingerprint-based criminal background check results, onsite visit results, risk level, and details if minimum data elements for reliance have been met. 3.1.2.10 Other screenings being offered, if applicable. 3.1.3 A detailed list of data sources and mechanisms utilized in the screening process and any source acquisition requiring DSS assistance. 3.1.3.1 Licensing data for SD providers for the specific licensing boards or types of providers must be called out, even if it is a subset of a different data source. 3.1.3.2 DSS will request access to DEX and PECOS on behalf of the offeror for the express purposes of executing the screening items for DSS, if required and requested. 3.1.3.3 DSS will assist with providing data from the South Dakota Board of Medical & Osteopathic Examiners.
