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2.1.4.4 Request for Taxpayer Identification Number and Certification
Federal Executive Orders 12549 and 12689 require HHSC to screen each potential provider to determine whether each has a right to obtain a contract in accordance with federal regulations on debarment, suspension, ineligibility, and voluntary exclusion. Each provider must also screen each of its providers who supply services to clients of Medicaid or other State healthcare programs. This form is required for all applicants.
The Internal Revenue Service (IRS) W-9 form is completed and submitted by all providers, excluding performing providers of a group.
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