Medicare AdvantageAdministrativeHigh impact
22-515 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
Healthcare providers must regularly monitor federal and state exclusion lists (OIG LEIE, SIPL, CMS Preclusion List) to ensure they are not excluded from participation in federally funded programs. Effective September 6, 2022, providers on these exclusion lists will be terminated from all product lines, which would prevent reimbursement for services rendered.
Action Required
Immediately: Billing and credentialing staff must check provider exclusion status monthly by accessing the OIG LEIE website, SIPL database, and CMS Preclusion List through the Health Net provider portal. Verify all employed physicians, contracted providers, and ancillary staff are not on these lists. Being listed will result in contract termination and loss of reimbursement for all services.