Medicare AdvantageAdministrativeHigh impact
24-130m Update to the Provider Suspended and Exclusion Lists
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Health Net requires providers to regularly verify eligibility against federal and state exclusion lists to avoid termination. New access to the Federal Employee Health Benefit Plan exclusion lists is now available through the provider portal, with monthly verification required for all participating providers.
Action Required
Immediately: All providers must establish monthly verification process to check OIG LEIE, SIPL, RPD, CMS Preclusion List, and FEHBP exclusion lists via Health Net provider portal. Access lists through provider portal > Provider Reports > Healthnet.com > Working with Health Net tab > Regulatory > Medicare Information. Conduct 12-month claims look-back review for any identified excluded providers. Notify Federal Employee Health Benefit Plan members if their provider becomes unavailable. Failure to verify eligibility regularly may result in provider termination from all affected lines of business.