MHCP Enrolled Providers

Excluded Provider Lists

Providers must check both the federal and state exclusion lists for individuals or entities that provide services to MHCP members.

Federal Exclusion List

The Office of Inspector General (OIG) List of Excluded Individuals/Entities (LEIE) provides information to the health care industry, patients and the public about individuals and entities who are currently excluded from participation in Medicare, Medicaid and all other federal health care programs. Individuals and entities who have been reinstated will no longer be on the OIG LEIE.

Verify that none of your employees are on the federal OIG LEIE

Continue to check the OIG LEIE in addition to the MHCP lists when you employ or enter into contracts with individuals or entities to provide services or items to MHCP members. MHCP recommends that all providers develop an ongoing process to confirm that the provider and any employees are not on the list. Keep all verifications for your own records.

MHCP Exclusion Lists

MHCP publishes two exclusion lists: one for excluded group providers and one for excluded individual providers. These Minnesota Exclusion Lists are updated monthly. Individual or group providers may be on the Minnesota list before being added to the OIG’s LEIE.

Excluded Group Providers

Excluded Individual Providers

Verification

To verify information that may not be clear on the list, such as a person with a similar name, or a person with the same name but the list shows as a different provider type, call the Provider Call Center at 651-431-2700 or 800-366-5411. The call center representative will request identifying data, including but not limited to the tax ID number (EIN/FEIN), Social Security number (SSN) or date of birth. MHCP uses this information to confirm whether the person you are calling about matches the person displayed on the excluded providers list. The call center representative will only verify whether the information you provide matches the identifying information.

Removal from the MHCP Exclusion Lists

A provider who is on the list must go to the Surveillance and Integrity Review Section (SIRS) to request removal from the list. This information is in the letter sent from SIRS when the provider was first added to the list. SIRS will notify MHCP provider enrollment directly when a determination is made to remove an entity from either of the MHCP exclusion lists.

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