0 SCOPE OF WORK The Division of Medical Services is requesting proposals for a Contractor to provide access to a national validated provider database to serve as our streamlined enrollment process for prescribers to ensure that those prescribers have been determined to be eligible to prescribe under all applicable state and federal requirements. Validated Provider File Successful Offeror shall provide a data file weekly of national validated providers in a file layout format as mutually determined by the Offeror and DSS. An example file layout is found in Exhibit 1. Providers response should include a proposed file layout. Providers must be validated for inclusion on the file per CMS requirements for provider screening. The Offeror’s response should indicate what screening requirements can be met, the sources of information used, and the frequency in which data is updated. The Offeror will complete and adhere to the screening items. The Offeror should populate responses in Exhibit 2 as appropriate to include: 3.1 Confirmation of the ability to use the file layout and proposed SFTP mechanism. 3.2 A listing of what screening activities will be completed, with a response to all the items below: 3.2.1 Use National Plan & Provider Enumeration System (NPPES) data to verify the type and status of NPI. 3.2.2 Check the System for Award Management (SAM) to determine exclusion status. 3.2.3 Check the Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) to determine exclusion status. 3.2.4 Utilize the Social Security Administration Death Master File (DMF) to verify social security numbers and dates of death. 3.2.5 Utilize DEX to its fullest extent to identify individuals and current or historical issues including terminations taken by other State Medicaid Agencies or Medicare. 3.2.6 Verify the servicing location address, which must be a street address, exists (optional). 3.2.7 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. 3.2.8 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. 3.2.9 Other screenings being offered, if applicable.
