Part 4 - Iowa Medicaid Enterprise

RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsFigure 9.1.2.1-48. Application of an OIG Sanction. eCAMS uses unique status values to capture sanctiondetails. The business status values are searchable from the Provider List page allowing easyidentification of all providers sharing a specific type of sanction.Sanction actions may also be tracked through the related Case in the Case Management feature ofeCAMS. Team Noridian's response in section 9.1.2.1.2, Requirement PR1.07, for further discussion ofCase Management for providers.PR2.05.01eCAMS supports interfaces and validation of providers for all of the following:• NPPES - NPI• OSCAR - CLIA• IRS and SSA TIN verification• Iowa Board of Medicine• Social Security Administration - (Death notices)• Automated Clearing House (ACH) Deposit Information - Banking details provided on enrollment forACH payments• Drug enforcement agency - (DEA) numbers• Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE)• NABP/NCPDP Pharmacy Provider Numbers• Occupational Licensing Boards (new)• State Sanction Organizations (new)• State HIE Organization (new)Key information entered on the provider's enrollment application is matched for all of the above asapplicable to the type of enrollment. Following initial validation and enrollment approval, any change tothe provider's database record triggers re-validation of the required credentials.Team Noridian will develop a new process to automatically generate termination notices and eitherautomatically terminate the provider or suspend the termination status change for IME approvaldepending on the type of condition identified.Several other interfaces related to provider management are supported in eCAMS Financials BusinessArea. These interfaces include Annual 1099s in both paper and electronic format, banking transactioninformation including valid and invalid debit card and electronic funds transfer details.PR2.06On a nightly basis, eCAMS performs an automatic sweep of all enrolled provider data to identify pendingexpirations for credentials required for the provider’s taxonomies and associated Department programs.The nightly process reviews the credentialing requirements housed in the eCAMS Credentialing Matrixand identifies any required credential that is pending expiration. eCAMS then automatically prepares9.1.2.1 | 64