[HISTORY: Adopted by the Board of Commissioners of York County 3-13-2013 by Ord. No.
2013-02.[1] Amendments noted where applicable.]
[1]
Editor's Note: The preamble to this ordinance, which
provides background information regarding the Exclusion Screening
Policy, is on file in the office of the York County Board of Commissioners.
A.
The purpose of this chapter is to comply with federal and state mandates
to screen employees, independent contractors, business vendors, key
providers and governing board members to verify that they have not
been involved in adverse governmental actions related to fraud, patient
abuse, licensing board sanctions, license revocation/suspension/surrender,
or have defaulted on Health Education Assistance Loans.
B.
York County government and its related entities are committed to
maintaining high-quality service and integrity in their financial
and business operations. Therefore, all necessary steps will be taken
to insure that health-care-related employees, providers, contractors,
prescribing/authorizing physicians, etc., that provide and/or perform
services for or on behalf of the County have not been the subject
of adverse governmental actions and/or excluded from the federal health
care programs.
As used in this chapter, the following terms shall have the
meanings indicated:
An inspection process for minimizing risk in continuing the
employment of or hiring individuals or contracting with business entities
that have been involved in adverse governmental actions related to
fraud, patient abuse, licensing board sanctions, license revocation/suspension/surrender,
or have who have been excluded from federal health care programs.
A.
A County Compliance Committee, consisting of the County Administrator,
as Chairman and Compliance Officer, the Director of Human Resources,
the Director of Human Services, the Administrator of the County Nursing
Home, Warden of the York County Prison, the York County Court Administrator,
the York County Controller and the York County Treasurer, is hereby
established.
B.
The purpose of the Compliance Officer and Committee is to assure
that the County of York is in full compliance with federal and state
law concerning the screening requirement for the lawful receipt and
use, by the County, of federal and state revenue funds that require
screening under federal or state law.
C.
The Committee is authorized to and shall promulgate policies and
procedures that it determines are required to efficiently carry out
the intent and purpose of this chapter.
A.
Unless prohibited by law or a legally enforceable labor contract,
York County government does not employ or retain any employee, consultant,
volunteer, contractor or vendor who is listed by any federal or state
agency as excluded, debarred, suspended or otherwise ineligible to
participate in federal and/or state programs, e.g., Medicaid and Medicare,
and whose retention or employment or service would violate federal
or state law.
B.
The County will conduct monthly exclusion screening of all County
employees, contractors, and providers, and screening of all elected
and appointed officials that have authority to grant appropriations
or that contribute to the development or execution of policy as these
actions relate to the use of Medicaid, Medicare, Title XX and any
federal funds that require screening. In addition, for employees that
require specific medical/healthcare license/certification in order
to perform their duties, these credentials will be verified with appropriate
licensing and disciplining authorities.
C.
Individuals and entities excluded from federal health care programs
will be prohibited from holding a position, or conducting business,
with the County in any area that is directly or indirectly funded
by a state or federal program that bars participation by such excluded
individuals and entities.
D.
If an exclusion check indicates that a potential elected or appointed
official has been excluded from federal or state health care programs,
the individual must abstain from any vote on any measure before the
board that relates to programs or activities that are directly or
indirectly funded by a state or federal program that bars participation
by such excluded individuals.
E.
If a determination is required regarding whether an activity is directly
or indirectly funded by a state or federal program that bars participation
by excluded individuals, the determination shall be made by the Compliance
Committee in consultation with the County Solicitor. If an employee
or business seeks an appeal of that determination, that appeal shall
be heard and decided by the County Administrator and reported to the
County Commissioners.
F.
Any disciplinary action for employees must follow the removal and
other disciplinary action policies established by applicable law and
provisions of collective bargaining agreements. Subject to the foregoing,
any applicant or employee, or elected or appointed official, who is
determined to be excluded from federal health care programs shall
not be eligible for employment with the York County government if
the employment involves any area that is directly or indirectly funded
by a state or federal program that bars participation by such excluded
individuals and entities. In the event an employee is found listed
with a positive exclusion record, the employee will be immediately
placed on administrative leave, pending investigation, and the findings
will be reviewed by the Human Resources Department. Any employee having
found to have a positive exclusion record is subject to termination.
G.
The County Compliance Committee will conduct an annual audit to verify
that the County's screening exclusion policy is being enforced.
A.
The County will conduct exclusion checks of the following sources
to determine if the individual or entity's name appears on the
lists:
(1)
Pennsylvania Medicheck List: a data base maintained by the Department
that identifies providers, individuals, and other entities that are
precluded from participation in Pennsylvania's MA Program: http://www.dpw.state.pa.us/
learnaboutdpw/fraudandabuse/m edicheckprecludedproviderslist/S 001152.
If an individual's resume indicates that he/she has worked in
another state, providers should also check that state's individual
list.
(2)
List of Excluded Individuals/Entities (LEIE): a database maintained
by HHS-OIG that identifies individuals or entities that have been
excluded nationwide from participation in any federal health care
program. An individual or entity included on the LEIE is ineligible
to participate, either directly or indirectly, in the MA Program.
Although the Department makes best efforts to include on the Medicheck
List all federally excluded individuals/entities that practice in
Pennsylvania, providers must also use the LEIE to ensure that the
individual/entity is eligible to participate in the MA Program: http://oig.hhs.gov/fraud/exclusions.asp.
(3)
Excluded Parties List System (EPSL): a worldwide database maintained
by the General Services Administration (GSA) that provides information
about parties that are excluded from receiving federal contacts, certain
subcontracts, and certain federal financial and nonfinancial assistance
and benefits: https://www. sam.gov/portal/public/SAM/.
B.
Immediately self-report any discovered exclusion of an employee or
contractor, either an individual or entity, to the Bureau of Program
Integrity:
(1)
Via e-mail through the MA Provider Compliance form at the following
link: http://www.dpw.state.pa.us/learnaboutdpw/fraudandabuse/m aprovidercompliancehotlineresponseform/index.htm;
(2)
By U.S. mail at the following address:
Bureau of Program Integrity
Commonwealth of Pennsylvania
P.O. Box 2675
Harrisburg, PA 17105-2675; or
(3)
By fax at 1-717-772-4655 or 1-717-772-4638.
C.
The County Human Resources Director will ensure that exclusion checks
are performed on candidates for employment at the point of offer of
employment and for elected and appointed County officials that have
authority to grant appropriations or that contribute to the development
or execution of policies as these actions relate to the use of Medicaid,
Medicare or other federal funds. The County Human Resources Director
will maintain the results of all exclusion checks for employees and
governing board members, including all elected and appointed officials,
and will report this information to the County Compliance Committee
at the time of the annual compliance report.
D.
The first line of responsibility for screening contractors shall
be the County Administrator (Compliance Officer) and all department
heads. These individuals will ensure that exclusion checks are conducted
prior to recommending, approving or entering into an agreement with
contractors providing health-care-related services. If the exclusion
check indicates that a contractor has been excluded from federal or
state health care programs, the contract will not be executed until
a determination is made by the County Administrator (Compliance Officer)
as to whether the contract pertains to activities subject to the prohibition
on participation by excluded entities.
(1)
The County Administrator and department heads will ensure that all
contracts entered into by the County will contain a certification
that the federal or state government does not exclude the contractor,
its employees, or subcontractors.
(2)
Each department head is responsible for conducting the screening
and attaching of a certification form of compliance. This form shall
be attached to the contract and become part of the contract documents
when placed on the agenda for approval by the Commissioners. It is
understood that the certification shall become a permanent part of
the contract and be affixed as one of the contract documents, which
will be included for permanent retention. The language of the Certification
document shall be in the following form:
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( )
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a.
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This contract does not require the screening of individuals
or entities as excluded individuals or entities under federal law.
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( )
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b.
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This contract involves the use of federal or state funds that
require screening for excluded individuals and such screening has
been done.
I certify the above is true and this certification is made under
penalties of law and the provisions of 18 Pa.C.S.A. § 4904.
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(3)
The County Controller, who is the custodian of all contracts, shall check all contracts that require screening and verify that such screening was done as required in Subsection D(2), above, and shall maintain the results of all exclusion checks as part of the contract documents. The Controller will report this information to the County Compliance Committee at the time of the annual compliance report. Should the County Controller find that the contract documents do not contain a certification which excludes the need for a screening check, the Controller shall contact the Compliance Officer and the department head to obtain such certificate so that it may be maintained as a permanent part of the contract documents.
E.
The County Administrator or the appropriate department heads assigned
by the County Administrator shall ensure that an exclusion check of
all existing health care contractors is conducted monthly through
to the end of the contract performance period. If the exclusion check
indicates that a contractor has been excluded from federal or state
health care programs, the contract will be terminated. The County
Administrator shall maintain the results of all exclusion checks and
will report this information to the County Compliance Committee at
the time of the annual compliance report.
F.
Any County departments working directly with physicians and health
care practitioners will ensure that an initial exclusion check is
conducted on each practitioner who prescribes or orders Medicaid or
Medicare funded goods or services, and then monthly thereafter. If
the exclusion check indicates that a practitioner has been excluded
from federal or state health care programs, the services or goods
will not be billed to Medicaid or Medicare. The results of all exclusion
checks for physicians and health care practitioners will be reported
to the County Compliance Officer at the time of the annual compliance
report.
G.
Certification by contractor.
(1)
All contracts that require screening checks shall contain the following
certification by the contractor:
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1.
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Certification:
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Contractor certifies that any statement made herein is known to be punishable under law and hereby states and verifies, under all penalties of law provided for official statements (18 Pa.C.S.A. § 4904), that exclusion screening, as defined and required by federal law in Part II, Chapter 204, of the York County Code, has been complied with and that the neither the contractor nor any employee of the contractor is an excluded person under federal law. Contractors shall, in addition, to this certification, also provide a monthly certification during the term of this contract, certifying that exclusion screening has been done and neither the contractor nor any employee of the contractor has been identified as an excluded person under federal or state law.
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Contractor certifies understanding that the failure to comply
with the screening requirements mentioned above is a ground for termination
of this contract.
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(2)
If a screening check reveals an excluded entity or employee, this
fact shall immediately be reported to the County's Compliance
Officer.
(3)
Should a contractor fail to comply with this provision, the contractor
shall hold the County harmless from all claims by any federal or state
agency arising from the failure of the contractor to either screen
or report the result of screening to the County.
