Provider termination and exclusion list
The following lists contain:
- Individuals or entities whose participation in the Medicaid program has been terminated for cause under the provision of WAC 182-502-0030 (HCA) or 388-71-0551; 388-71-0540; 388-71-0544; 388-110-260 (DSHS).
- Medicaid providers who have been excluded from participation (see 42 CFR 1001).
Not every action taken by the Department of Social and Health Services (DSHS) or the Health Care Authority (HCA) involves a finding of wrongdoing (see WAC 182-502-0030(b)). Individuals terminated without cause pursuant to WAC 182-502-0040 are not included on this list.
The Affordable Care Act requires that all ordering physicians or other professionals who prescribe, order, or refer services to Medicaid or provide services under the State Plan or under a waiver of the plan to be enrolled as participating providers (see 42 CFR 455.410(b)). Therefore, any non-enrolled provider, including any provider who is terminated from the Medicaid Program, for any reason, is not permitted to provide services to Medicaid recipients.
*These lists were updated January 10, 2020. All attempts are made to ensure the accuracy of the information. HCA and DSHS are not liable for any errors or omissions. 42 CFR 1002.212 requires notification of the public and to beneficiaries of excluded providers.
†Downloading and editing spreadsheets will not affect original files.