Social Security Death Master File and LEIE Monitoring

Medical Provider Resources recognizes the need to meet federal and state regulations as they pertain to basic credentialing and monitoring functions. The Social Security Death Master File is a computer database file made available by the United States Social Security Administration since 1980. The file contains information about persons who had Social Security numbers and whose deaths were reported to the Social Security administration from 1962 to the present, or persons who died before 1962, but whose Social Security accounts were still active in 1962. MPR is registered with the Limited Access Death Master File (LASMF) as an entity with a genuine fraud prevention interest.

The final rule published in the Federal Register on June 1, 2016 describes how institutions and others may become certified to received data from the LADMF. Per the CMS Medical Program Integrity Toolkit to Address Frequent Findings 42 CFR 455.436, “The Social Security Administration’s Death Master File (SSADMF) must be searched at the time of enrollment to ensure that Medicaid is not being billed in the name of a deceased provider.” Disclosure of search results outside of the MPR service agreement is strictly prohibited under 15 CFR 1110.200. Furthermore, according to the CMS Medical Program Integrity Toolkit to Address Frequent Findings for federal database checks (42 CFR 455.436), “In addition to conducting their own ongoing exclusion searches, states should instruct all enrolled Medicaid providers to check their own employees and contractors for exclusions against the LEIE – List of Excluded Individuals and Entities- at the time of hiring and on a monthly basis.”

In response to the federal regulations, the Social Security Death Master File at the time of initial appointment, in addition, MPR will query the LEIE monthly on behalf of any provider covered under a MPR Centralize Verification Service (CVS) agreement. The findings of the LEIE monthly query will be provided to each participating entity in the On-going Monitoring Service (OMS) report.

Sources:
Medicaid Program Integrity – Toolkits to Address Frequent Findings: 42 CFR 455.436
State Medicaid Director Letter #09-001, dated Jan. 16, 2009
42 CFR 1003.102 Basic for civil money penalties and assessments
42 CFR 1002.3 Disclosure by providers and State Medicaid agencies
NTIS Final Rule on Limited Access Death Master File

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2 Responses to Social Security Death Master File and LEIE Monitoring

  1. Terapi Mata says:

    Aw, this was an extremely nice post. Taking the time and
    actual effort to produce a great article… but what can I say… I procrastinate
    a lot and don’t manage to get nearly anything done.

  2. Ashley says:

    This is a great article. Does anyone know how this is handled at other facilities? Specifically who is responsible for running the monthly queries?

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