Prior to using the services of any CE provider (including CE providers who are also treating sources):

1. 1. 

   check the System of Award Management (SAM);

2. 2. 

   verify medical licenses, credentials, and certifications with state medical boards, psychology boards, and other state professional certification bodies;

3. 3. 

   annotate the provider file with the:

   • •

     date and name of the DDS employee verifying the license and the source of verification (e.g., state licensing agency webpage, SAM database); or

   • •

     name of the individual who provided the credential verification.

4. 4. 

   obtain a signed License and Credentials Certification from the CE provider and retain it in a file.

5. 5. 

   maintain records for 6 years, unless tied to an open audit, per DI 39509.015A2.

   (For information on License and Credentials Certification for Consultative Examination Provider and Certification of All Support Staff, see DI 39569.400.)

   NOTE: 

   At the time of an established agreement or contract to work with the DDS, the CE provider must sign the License and Credentials Certification statement. The DDS will obtain a new signed certification:

   • •

     annually, or

   • •

     when there is a change with the CE providers support staff that assists with CEs.

Where possible, subscribe to the state or medical board’s service that provides alerts for sanctions against a license or certificate holder. Consider more frequent tracking if the DDS does not subscribe to alerts.

DDS may require all CE providers to include their professional license numbers with expiration dates on all CE reports.

Conduct license checks of CE providers (including treating sources) used by the DDS on a rolling basis, including providers who perform CEs near and across the borders of neighboring States, specifically:

1. 1. 

   Verify license renewals within 30 days of renewal date.

2. 2. 

   Conduct periodic licensure reviews prior to renewal dates to ensure that licenses are active.

3. 3. 

   Review the SAM for each CE provider at least annually.

4. 4. 

   Confirm with the DDS in the neighboring state that the medical source has a current license and not federally excluded.

5. 5. 

   Maintain records for 6 years, unless tied to an open audit, per DI 39509.015A2. and annotate the provider file with the:

   • •

     date and name of the DDS employee verifying the license and the source of verification (e.g., state licensing agency webpage, SAM database); or

   • •

     date and name of the individual who provided the credential verification.

Obtain and retain a signed statement from each CE provider

• •

  Maintain records for 6 years, unless tied to an open audit, per DI 39509.015A2.

Certify that all support staff that assist with CE:

• •

  meet the licensing or certification requirements of the state; and

• •

  are not currently excluded, suspended, or otherwise barred from participation in Medicare or Medicaid programs or any other Federal or federally assisted programs.

To view the License and Credentials Certification for Consultative Examination Provider and Certification of All Support Staff see DI 39569.400.

Prior to using the services of any MC/PC:

1. 1. 

   check the System for Award Management (SAM);

2. 2. 

   verify medical licenses, credentials, and certifications with state medical boards, psychology boards, and other state professional certification bodies; and

3. 3. 

   maintain records for 6 years, unless tied to an open audit, per DI 39509.015A2. and annotate the:

   • •

     date and name of the employee verifying the license and the source of verification (e.g., state licensing agency webpage, SAM database); or

   • •

     date and name of the individual who provided the credential verification.

Conduct license checks for existing MC/PCs on a rolling basis, specifically:

1. 1. 

   Verify license renewals on the renewal date.

2. 2. 

   Conduct periodic licensure reviews prior to renewal dates to ensure that licenses are active.

3. 3. 

   Review the SAM for each MC/PC at least annually.

4. 4. 

   Maintain records for 6 years, unless tied to an open audit, per DI 39509.015A2. and annotate the:

   • •

     date and name of the employee verifying the license and the source of verification (e.g., state licensing agency webpage, SAM database); or

   • •

     date and name of the individual who provided the credential verification.