As required by the Medicare and Medicaid Patient Protection Act
of 1987, the Health and Human Services Commission (HHSC) identifies providers or
employees of providers who have been excluded from state and federal health-care
programs. Providers excluded from Texas Medicaid and the DSHS Family Planning Program must not
order or prescribe services to clients after the exclusion date. Services
rendered under the medical direction or under the prescribing orders of an
excluded provider also will be denied. Providers who submit cost reports cannot
include the salaries, wages, or benefits of employees who have been excluded
from Medicaid. Also, excluded employees are not permitted to provide Medicaid
services to any client.
Medicaid providers are responsible for checking the exclusion
list on all employees upon hiring and periodically thereafter. Providers are
liable for all fees paid to them by Texas Medicaid for services rendered by
excluded individuals. Providers are subject to a retrospective audit and
recoupment of any Medicaid funds paid for services. It is strongly recommended
that providers conduct frequent periodic checks of the HHSC exclusion list. The
HHSC-Sanctions Department submits updates to the exclusion list periodically and
the updates appear on the website weekly.
Previously, the list of excluded providers was published in the Texas
Medicaid Bulletin, which was discontinued after the publishing of the
September/October 2012 edition. The files on this page include the excluded
providers that have been added since the bulletin was discontinued.