Excluded Providers List

Disclaimer

This list should not be considered comprehensive of all providers excluded from participation in the Vermont Medicaid program; action by other federal or state entities may also result in exclusion. The providers identified herein are those that have been excluded by the Vermont Department of Health Access and the Agency of Human Services. This list may or may not include providers excluded due to action taken by other federal or state entities. This list contains the names of providers whose participation with Vermont Medicaid was terminated “for cause”, which may include conduct deemed as potentially detrimental to the Vermont Medicaid program.

Consideration

  • If your name appears on the Excluded Providers List and your exclusion term has expired, you may complete a new application for consideration to participate with Vermont Medicaid. Information can be found at https://www.vtmedicaid.com/#/provEnrollDataMaint
  • If your name appears on the Excluded Providers List and your exclusion term has expired, you may request that your name be removed from the Excluded Providers List. Requests for removal of Provider name(s) from the Excluded Providers List should be submitted to the address below.
  • If you wish to have a reconsideration of DVHA’s decision to preclude you from participation with Vermont Medicaid your request must include documentation with compelling and extenuating circumstances. Reconsideration information can be sent to the address below.

Please submit re-consideration requests to

Member and Provider Services
Department of Vermont Health Access
280 State Drive, NOB 1 South
Waterbury, VT 05671-1010

Questions pertaining to exclusions can be sent to vtproviderenrollment@gainwelltechnologies.com

Affordable Care Act Requirements

The Affordable Care Act requires mandatory enrollment for all ordering physicians or other professionals who prescribe, order, or refer services to Medicaid or provide services under the State Plan or under a waiver of the plan (see 42 CFR 455.410(b)). Therefore, any non-enrolled provider, including any provider who is terminated from the Medicaid Program, for any “for cause” reason, is not permitted to provide services to Medicaid recipients. Medicaid providers and their agents are reminded that the Vermont Excluded Provider list is not all-inclusive. Additional information about provider exclusions is available but not necessarily limited to the information contained on the following websites:

Excluded Providers List

Please contact vtproviderenrollment@gainwelltechnologies.com for archived list(s) of Exclusions The most current list is below.