Agencies
Services
Provider Notice issued 10/31/05
Terminated/Suspended Providers and Barred Entities and Individuals
| To: | All Participating Medical Assistance Programs Providers |
| Date: | October 31, 2005 |
| Re: | Terminated/Suspended Providers and Barred Entities and Individuals |
The purpose of this notice is to remind providers that the Illinois Department of Healthcare and Family Services (HFS) maintains a sanctions list of terminated or suspended providers and barred entities and individuals on the Office of Inspector General’s (OIG) Web site. The site is located at:
The sanctions list contains the names of providers and individuals who are currently terminated, suspended, barred, voluntarily withdrawn or otherwise excluded from participation in the Illinois Medical Assistance Program.
Pursuant to 305 ILCS 5/12-4.25, the department has the authority to deny payment and/or impose sanctions on enrolled providers seeking reimbursement for services provided by an entity or individual on the sanctions list. Specifically, no program payment will be made by the department for any items or services for which a sanctioned individual or entity serves as an employee, administrator, operator or in any other capacity related to the items or service on or after the date the individual or entity is shown to be ineligible on the Web site.
As a provider, you have an affirmative obligation to ensure you do not submit claims to the department for payment under the circumstances described above. To ensure you do not submit such claims, the department expects you to check the sanctions list prior to employment or utilization of an individual or entity and periodically thereafter. Payments made for services provided by ineligible persons or entities may be recovered even though the service was provided and was otherwise completely legitimate. In addition, your future participation in the Illinois Medical Assistance Program could be terminated or suspended.
If a person or entity you are considering using is on the sanctions list, the department recommends that you confirm eligibility with the OIG. Inquiries must be in writing and submitted either by e-mail to HFS.OIGWebmaster@illinois.gov or mailed to:
Healthcare and Family Services
Office of Inspector General
Administrative Services Unit
404 North Fifth Street
Springfield, Illinois 62702
As you may know, the name of the Department of Public Aid (DPA) has changed to Healthcare and Family Services, HFS for short. We are in the process of updating forms, handbooks, and the Internet with our new name. However, until existing supplies are exhausted, we will continue to use materials bearing the former DPA name and logo. Either version of documents should be considered official regardless of the department name they bear. Only our name has changed. HFS’s programs, staff, office locations, mailing addresses and phone numbers remain the same as DPA’s. We believe our new name more clearly reflects our mission of service to the State of Illinois including providing access to health care for over two million Illinoisans. In our work, we deeply appreciate your participation in our programs.
Providers wishing to receive e-mail notification, when new provider information has been posted by the department, may register at the following HFS Web site:
If you have any questions or need further information regarding this informational notice, or your obligations related to it, please feel free to contact the OIG’s Administrative Services Unit at 217-524-0757.
John C. Allen, IV
Inspector General Administrator
Office of Inspector General
Anne Marie Murphy, Ph.D.
Administrator
Division of Medical Programs