Provider Eligibility: Ineligibility of Suspended Providers

A provider suspended from participation in MassHealth is not eligible to participate during the period of such suspension, cannot receive payments for any services rendered to members during the period of such suspension, and is not eligible to participate until such time as a new application is filed, reviewed, and approved, and the provider contract is effective. If the violations resulted in overpayments, the MassHealth agency may deny the participation of such provider until such time as arrangements satisfactory to the MassHealth agency have been made for the restitution of all overpayments. The MassHealth agency has discretion to deny a new application after review of the any prior for cause suspensions, if in the judgment of the MassHealth agency, such participation would (A) threaten the health, welfare, or safety of members; or (B) compromise the integrity of the MassHealth agency. (130 CMR 450.218 through 450.220 Reserved) 2. Administrative Regulations