Last Update: 11/22/2019
To determine if an individual or entity is excluded (terminated or suspended) from participating in the Nebraska Medicaid program, see the attached pdf titled 'Nebraska Medicaid Excluded Providers'. If you have questions regarding an individual or entity that is excluded, contact the Nebraska Medicaid & Long-Term Care Program Integrity unit at P.O. Box 95026, Lincoln, NE 68509-5026, or via e-mail at DHHS.MedicaidProgramIntegrity@nebraska.gov.
Nebraska Medicaid excluded providers - Last updated November 22, 2019
In order to be considered for removal from the Nebraska Medicaid excluded providers list and reactivated as a Nebraska Medicaid provider, the following questionnaire must be completed and submitted:
Nebraska reactivation questionnaire
Information about federal exclusions, including databases of excluded individuals and entities, can be found on the Office of Inspector General's website located at http://oig.hhs.gov/exclusions/ and at the System for Award Management website located at https://www.sam.gov.
Suspension from participation: An exclusion from participation in NMAP for a specified period of time.
Termination from participation: A permanent exclusion from participation in NMAP.
When a provider is suspended or terminated from NMAP, NMAP may not make reimbursement for services, items, or drugs that are provided, referred, furnished, or prescribed by the suspended or terminated provider or caused to be provided, referred, furnished, ordered, or prescribed for a Medicaid client.
Suspension or termination from participation of any provider shall preclude the provider from submitting claims for payment, either personally or through any clinic, group, corporation, or other association, to the Department for any services or supplies provided under NMAP, except for those services or supplies provided before the suspension or termination.
No clinic, group, corporation, or other association which is a provider of services shall submit claims for payment to the Department for any services or supplies provided by a person within the organization which has been excluded from participation in NMAP except for those services or supplies provided before the suspension or termination. If these provisions are violated by a clinic, group, corporation, or other association, the Department may suspend or terminate the organization and/or any individual person within the organization responsible for the violation. A provider shall not submit any claims to NMAP that contain the costs of services provided by excluded persons.
To determine if a facility, provider, employee, or contractor is excluded or prohibited from participation in Medicare and Medicaid on a nationwide basis either contact the Program Integrity unit or visit the following websites: HHS-OIG located at http://oig.hhs.gov/ and at the System for Award Management website located at https://www.sam.gov. Providers enrolled in Nebraska Medicaid are required to screen facilities, providers, employees, and contractors for exclusion status using both websites.