State Exclusion List

Under A.R.S. § 36-2930.05, AHCCCS may exclude providers pursuant to rules adopted by AHCCCS, which are outlined in Arizona Administrative Code (A.A.C.) Title 9, Chapter 22, Article 18. AHCCCS, in its sole discretion, may exclude entities and individuals for any of the reasons outlined in A.A.C. R9-22-1802. A.R.S. Sec. 36-2930.05(E) defines "exclude" as: "items and services furnished, ordered or prescribed by a specified individual or entity will not be reimbursed by the administration, a contractor or any agent of the administration or a contractor. Exclude includes the termination of a provider agreement or the administration's refusal to enter into a provider agreement."

Reinstatement of excluded entities and individuals is not automatic. Excluded entities and individuals may apply for reinstatement following the expiration of their exclusion as required under A.A.C. R9-22-1805. Providers are also notified of the earliest date they may apply to be removed from the exclusion list.

Providers are informed of the reason for the exclusion in a Notice of Exclusion. Excluded entities and individuals have due process rights, beginning with the right to a fair hearing, in order to appeal their exclusion. Appeal rights are laid out in the exclusion notice that is sent to the provider when AHCCCS takes an exclusion action. The Provider Due Process Info Sheet is an additional resource on the process, although it outlines the process for a Termination, all state Exclusions have the same due process rights and follow the same process.

If an exclusion is rescinded, the provider will be removed from the exclusion list. If an excluded entity or individual is reinstated following a successful application after the end date of their exclusion, their exclusion will be end dated in the exclusion list.

The document below provides a list of Arizona’s exclusions of providers and individuals under R9-22-1802. AHCCCS protects the personal identifying information of individuals in public postings, however the information may be available upon request, on a case by case basis. Please submit a request for this information to AHCCCSFraud@azahcccs.gov.

Current Provider Exclusions (Effective 12/20/2024)