42 CFR 422.503(b)(4)(vi) and 423.504(b)(4)(vi) — Compliance program requirements; CMS Medicare Managed Care Manual Ch. 21 / Prescription Drug Benefit Manual Ch. 9
CMS Medicare Advantage / Part D: FDR exclusion screening before hire and monthly
Sponsors must have an effective compliance program that applies to first tier, downstream and related entities; CMS guidance directs that employees and FDRs be screened against the OIG LEIE and the SAM exclusion list prior to hiring or contracting and monthly thereafter. source
Who it reaches
MA organizations and Part D sponsors, and every first-tier, downstream and related entity they contract with.
The record the rule expects
Per name, per month: LEIE file date, SAM read time, exact name/NPI, rows printed, did-not-answer states. The CMS Preclusion List is restricted to plans and is not read here — record your own read beside the receipt.
Free
Read one name now — every source, dated, hashed.
Free, once
500 names you already screened — the 48-hour comparison.
Sector receipt
/receipts/for/hospitals
Duty Sheet
One page per rule, generated on any receipt
Protocol template
Adopt it as yours; set every threshold
Questions readers ask
Can the receipt stand as the FDR's monthly evidence to the plan?
It is a dated record of the reads performed; the plan's delegation oversight decides what it accepts. The read_for field lets an FDR produce it on behalf of the plan.
This page quotes the rule and describes the record; whether your organization meets the rule is your compliance office's and counsel's reading. All rules · Methodology.