All PlansAdministrativeMedium impact
23-1119 Updates to Monitor Suspended and Excluded Lists to Prevent Getting Terminated
Health Net·CA·Prior Authorization
Effective date
Dec 19, 2023
We identified it
Jun 20, 2026
Summary
Health Net is adding the Federal Employee Health Benefit Plan (FEHBP) exclusion list to their provider monitoring process effective December 19, 2023. Providers on this list will be terminated from all Health Net products, and there will be a 12-month claims look-back review for affected providers.
Action Required
Immediately: Billing team must regularly monitor federal and state exclusion lists (at least monthly) to ensure practice is not listed on OIG LEIE, SIPL, RPD, CMS Preclusion List, or FEHBP exclusion lists. Access these lists through Health Net provider portal under Provider Reports or contact plan representative for FEHBP list. Failure to monitor could result in termination from all Health Net products.