Medicare AdvantageAdministrativeHigh impact
22-514 Monitor Suspended and Excluded Lists to Prevent Getting Terminated
Health Net·CA·Reimbursement
Effective date
Sep 6, 2022
We identified it
Jun 20, 2026
Summary
Health Net will terminate providers who appear on federal or state exclusion lists (OIG LEIE, SIPL, CMS Preclusion List) for all product lines, effective September 6, 2022. Billing teams must regularly monitor these exclusion databases at least monthly to ensure providers remain eligible for reimbursement and avoid contract termination.
Action Required
Immediately: Billing teams must establish monthly monitoring of provider exclusion lists through Health Net provider portal (Working with Health Net tab > Regulatory > Medicare Information) and OIG LEIE website. Verify all current providers are not on OIG LEIE, SIPL, or CMS Preclusion Lists. Create ongoing process to check new providers at credentialing and existing providers monthly. Failure to monitor will result in provider termination and claim denials.