List of Excluded Providers- Updated 02/09/17
Details of Excluded Provider List
Excluded individuals and entities are listed according to the type of provider they were at the time of exclusion; however, they are excluded from participating in providing services in the Medicaid program in all categories of service and in any capacity. The exclusion remains in effect until they are removed from this list.
The Office of the Inspector General maintains a national list of all individuals who are excluded from receiving reimbursement from Medicare and Medicaid. For a comprehensive list of all individuals, go to http://oig.hhs.gov/fraud/exclusions.asp.
What is an Excluded Provider?
An excluded provider is an individual or entity that is not allowed to receive reimbursement for providing Medicare and Medicaid services in any capacity, even if they are not on this listing by the Med-QUEST Division. Most exclusions are for a period of three to five years, although exclusion from Medicaid or other federally-funded health care programs can be permanent. The following website gives additional information on the effect of exclusions on participation in federal programs:
The Effect of Exclusion From Participation in Federal Health Care Programs
Medicaid Provider Responsibilities
Any provider participating or applying to participate in the Medicaid program must search Hawaii’s excluded provider list monthly and the List of Excluded Individuals and Entities (LEIE) on an annual basis to determine if any existing employee or contractor has been excluded from participation in the Medicaid program. In addition, any provider participating or applying to participate in the Medicaid program must search both lists prior to hiring staff to ensure that any potential employees or contractors have not been excluded from participating in the Medicaid program.