The Kentucky Department for Medicaid Services maintains a list of providers whose Medicaid provider agreements either have been terminated or who have been placed on an exclusion list.
An individual or entity terminated or excluded from participating in the Kentucky Medicaid program will not be reimbursed for services provided in any capacity or in any category under the Kentucky Medicaid program.
The termination or exclusion remains in effect until the provider is removed from this list. Where applicable and when determined, an end date is provided. It is the provider's responsibility to notify Kentucky Medicaid if the circumstances change which led to the termination and/or exclusion. If the provider meets the requirements of 907 KAR 1:671 and 907 KAR 1:672, a provider terminated by the Department for Medicaid Services may apply for re-enrollment in the Kentucky Medicaid program.
Any provider participating or applying to participate in the Kentucky Medicaid program must search the
list of excluded individuals and entities and the
System for Award Management on a monthly basis to determine if any existing employee or contractor has been terminated or excluded from participation in the Kentucky Medicaid program or has been nationally excluded from Medicare or Medicaid. Also, any provider participating or applying to participate in the Kentucky Medicaid program must search all lists prior to hiring staff to ensure that any potential employee or contractor has not been terminated and/or excluded from participating in the Medicare or Medicaid program.
Please note that the Kentucky Medicaid Program only lists providers terminated or excluded from the Kentucky Medicaid program. HHS/OIG excluded individuals and entities are not allowed to receive reimbursement for providing Kentucky Medicaid services in any capacity, even if they are not on the Kentucky Medicaid list.
On Jan. 16, 2009, the Centers for Medicare and Medicaid Services issued a letter to state Medicaid directors repeating a long-standing policy and clarifying federal statutory and regulatory prohibitions regarding providers from participation in federal health care programs. For more information please review the following letters.