Additional Background Check During NCTracks Enrollment

The System for Award Management (SAM) is the official U.S. government system that consolidated the capabilities of Central Contractor Registration (CCR)/FedReg, Online Representations and Certifications Application (ORCA), and Excluded Parties List System (EPLS). In accordance with § 455.436 (federal database checks), the SAM database must be used to determine if final adverse actions have been imposed that would disqualify an individual or organization from participation in the North Carolina Medicaid and NC Health Choice (NCHC) programs. This system must be used for all applicants and for all individuals and entities the applicant has identified as having a managing relationship and ownership.

As of January 4, 2016, the SAM database check is being applied to enrollment, re-enrollment, re-verification and Manage Change Request (MCR) processes where credentialing is required. NCTracks uses the SAM database to identify each applicant who should be disqualified from participation in the N.C. Medicaid Program or the NCHC Program because a final adverse action has been imposed on an individual or entity with a managing relationship to that applicant.

Note that if a new location is added and a negative SAM match is found for a managing relationship at that location, the location will be denied. If a managing relationship is added to an existing active location and that managing relationship has a negative SAM match, the location may be terminated. (The provider will receive a termination letter if the location is terminated.)

If an applicant is disqualified as a result of a SAM database match, an Application Denial Letter will be sent to the provider via email. Termination letters are sent to the provider’s Message Center Inbox and may also be sent via certified mail, depending on the reason. This is the same process in place today, but the letter will now include information regarding the SAM database match, if that is the cause of the denial or termination. Information regarding appeals is included in the denial and termination letters.