Medicare AdvantageAdministrativeMedium impact
24-128m Update to the Provider Suspended and Exclusion Lists
Health Net·CA·Reimbursement
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Health Net updated their provider exclusion monitoring requirements, now requiring monthly checks of federal and state exclusion lists including a new Federal Employee Health Benefit Plan (FEHBP) list accessible through their provider portal. Providers found on these lists will face immediate termination from applicable lines of business.
Action Required
Immediately: Billing team must establish monthly monitoring process to check provider exclusion lists through Health Net's provider portal (log in > Provider Reports > Working with Health Net tab > Regulatory > Medicare Information). Verify all current providers are not on OIG LEIE, SIPL, RPD, CMS Preclusion List, or new FEHBP exclusion lists. Document monthly reviews and flag any excluded providers for immediate action to avoid contract termination.