Terminated Provider List

At a glance

Published by

Colorado Department of Health Care Policy & Financing (HCPF)

Format

Excel workbook, with a separate Reinstated Provider List

Updates

Not stated by the publisher (dated file on the HCPF page)

Covers

Medicaid terminations for cause, Reinstatements

What is on the list

• HCPF calls it a termination list, not an exclusion list. A provider terminated for cause may not receive Medicaid reimbursement; the reasons are defined as “good cause” in 10 CCR 2505-10, Section 8.076.1.7.
• About 320 rows. Each row has the provider name, a “doing business as” name, the NPI, the termination authority and the termination effective date. Some rows have no NPI.
• Reinstated providers are removed from the termination list and appear on the separate Reinstated Provider List, with both the termination and reinstatement dates.
• Each edition has its effective date in the file name (for example, “ef. 9.1.26”), so open the files from the HCPF page rather than a saved link.

How to check a name against it

1. Download the current Terminated Provider List and Reinstated Provider List from the HCPF Provider Termination and Reinstatements page.
2. Search the provider name and “doing business as” columns for the person’s or organization’s name, then compare the NPI when one is listed.
3. Treat a name match as a potential match until the identity is confirmed with the publisher, using identifiers such as NPI, license number, date of birth or address.

Check the federal lists too

A state list covers that state’s program. The federal LEIE and SAM.gov lists apply everywhere, so a complete check includes them.