May and June Monthly Actions: Agency Took Licensure Action against 14 Providers, 20 Additional Providers Suspended or Terminated from the Medicaid Program

The Agency for Health Care Administration (Agency) issued final orders to 14 providers for failure to meet licensure requirements during the months of May and June.

There were two final orders to revoke an existing license, seven to deny a license renewal, one to deny a change of ownership (CHOW), and four that resulted in the provider surrendering its license. Some of these providers were enrolled in the Medicaid program and the Agency has terminated or is in the process of terminating their participation in the program.

In addition, 12 providers were issued final orders terminating them from participation in the Medicaid program and have been reported to the federal government for placement on the federal exclusion list, which prohibits them from participating in Medicaid and Medicare nationwide. The Agency also suspended eight providers from participation in the Medicaid program, prohibiting the providers from being paid for claims to the Medicaid program for furnishing, supervising a person who is furnishing, or causing a person to furnish goods or services.

Agency Medicaid terminations and suspensions typically result from failure to return funds due to the Agency within required timeframes; a charge, indictment, or guilty plea to a health care related crime; suspension, termination, or exclusion from Medicare or Medicaid in another state; or a license denial, revocation, suspension or termination by the licensing agency.

The chart below displays the Agency’s May licensure actions:

The chart below displays the Agency’s June licensure actions:

The chart below displays the Agency’s May Medicaid final order actions:

The chart below displays the Agency’s June Medicaid final order actions:

Further information about the actions and final orders can be found on the public records search page. Emergency orders, including moratoriums on admissions and suspensions, can also be found on the public records search page by searching the name of the facility.

The Agency encourages anyone who may have a concern or observes a problem in any health care facility or with any provider regulated by the Agency, to file a complaint by calling our consumer complaint line at 1-888-419-3456 or by reporting online here.

Tips about suspected fraud can be reported by calling the Attorney General’s Fraud Hotline at 1-866-966-7226 or the Agency’s Consumer Call Center at 1-888-419-3456. Anyone can report fraud online by visiting the Agency’s website.