A disqualified provider is a person or an organization that has been excluded from participation in federal or State funded health care programs including but not limited to Medicare or Medicaid. Any products or services that a disqualified provider furnishes, orders or prescribes are not eligible for payment under those programs. This payment prohibition extends to anyone who employs or contracts with the disqualified provider, as well as to any facility where the disqualified provider delivers services that might otherwise be reimbursable.
The links on this page will help providers determine whether the individuals they employ or contract with are excluded from the New Jersey Medicaid program. In addition, they provide information on individuals holding professional licenses in the State of New Jersey.
State of New Jersey Debarment List
The State of New Jersey Medicaid Fraud Division is responsible for the oversight and maintenance of the NJ Debarment List (medical code). All updates will be done at the end of each month. If you are responsible for verifying a provider, please refer to the list below. If you find a potential match, of a prospective employee, please complete the Exclusions Verification Form and return via email to: MFDVerifyMailbox@osc.nj.gov. Upon completion you will receive an auto reply with the next steps in the process. Any additional inquiries regarding an Exclusionary Action can also be made via the verify mailbox.
Click here for: State of New Jersey Medicaid Fraud Division Debarment List
*Any non-medical inquiry will not be processed or responded to, please contact the appropriate agency for such inquiries.
Applying for Reinstatement to the NJ Medicaid Program
If you are on the State of New Jersey Debarment list and wish to be considered for reinstatement to the New Jersey Medicaid program, please follow the instructions below.
Please note, reinstatement to the Medicaid program is not automatic, you must make a formal application following the period of your debarment by writing to Chief, Office of Legal and Regulatory Liaison, Division of Medical Assistance and Health Services (DMAHS), P.O. Box 712, Mail Code #3, Trenton, New Jersey 08625-0712. At that time, DMAHS will notify you if any additional materials are required in support of your application. You will be notified in writing of DMAHS' decision regarding your application.
*Please allow four weeks for processing, please do not make multiple inquiries regarding your application as this may result in further delays.