LIST OF INDIVIDUALS EXCLUDED FROM PARTICIPATING IN THE GEORGIA MEDICAL ASSISTANCE PROGRAM UNDER TITLE XIX OF THE SOCIAL SECURITY ACT OF 1935, AS AMENDED, AND O.C.G.A. §§ 49-4-140 et seq. (THE “MEDICAID PROGRAM”)
What is an Excluded Provider?
DCH-OIG is authorized to exclude certain individuals and entities (providers) from participating in federally funded health care programs, including Medicaid. Excluded individuals and entities are not permitted to receive reimbursement for providing Medicare and Medicaid services in all categories of service and in any capacity, including managed care.
Georgia List of Excluded Individuals/Entities
The Georgia Medicaid Exclusion List below is updated at least monthly.
List of Excluded Individuals - Updated 4/13/17
The excluded individuals and entities are listed in chronological order by the Sanction effective date. All exclusions remain in effect until they are removed from this list.
DCH-OIG has attempted to ensure that all of the information contained in this list is accurate, to the extent reasonably possible. However, the Agency makes no warranty or guarantee either express or implied concerning the accuracy of the content of the website. No posted information or materials provided are intended to constitute legal or medical advice.
National Exclusion List
For a comprehensive list of individuals and/or entities excluded from receiving reimbursement from Medicare and Medicaid services nationwide, go to: http://oig.hhs.gov/fraud/exclusions.asp (see List of Excluded Individuals and Entities (LEIE).
Please also check the System for Award Management at: https://www.sam.gov/ (formerly the Excluded Parties List System-EPLS).
Medicaid Provider Responsibilities
Any provider participating or applying to participate in the Georgia Medicaid program, including managed care entities, must search the Georgia Medicaid Exclusion List, in addition to the List of Excluded Individuals and Entities (LEIE) and the System for Award Management (SAM) on a monthly basis to determine if any existing employee or contractor has been excluded from participation in the Georgia Medicaid program and/or has been excluded, on a national level, from the Medicare and/or Medicaid program. Furthermore, any provider participating or applying to participate in the Georgia Medicaid program must search all above-referenced lists prior to hiring staff to ensure that any potential employees or contractors have not been excluded from participating in the Medicare and/or Medicaid program.
Providers are required to immediately report to the Department of Community Health, Provider Enrollment Section, any exclusion information discovered among employees or contractors.
If you do not find an answer to your question regarding content and information contained in the Georgia Medicaid Exclusion List, please contact Nichole Thompson, Director of Provider Enrollment at:
E-mail address: email@example.com
Georgia Department of Community Health
Medical Assistance Plans
Provider Enrollment Section
2 Peachtree Street NW, 37th Floor
Atlanta, GA 30303