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Zachary
Zachary, Lawyer
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Experience:  Contracts, Wrongful termination and discrimination
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Can a physician with temporary suspension of medicaid work

Resolved Question:

Can a physician with temporary suspension of medicaid work in another state?
Submitted: 1 year ago.
Category: Employment Law
Expert:  Zachary replied 1 year ago.
Hi,

When you say "temporary suspension of medicaid" what do you mean exactly?

Was the physician's license to practice revoked or suspended?
Customer: replied 1 year ago.
No the State license is not revoked not susoended
Expert:  Zachary replied 1 year ago.
So, can you explain what you mean by "temporary suspension of medicaid".

Do you mean that the physician's authority to request payment through medicaid was suspended by the State of Arkansas?
Customer: replied 1 year ago.
Yes
Expert:  Zachary replied 1 year ago.
Thank you for clearing that up.

Yes, the physician may work in a different state, as long as the physician obtains a license in that state.
Customer: replied 1 year ago.
Is it necessary to inform another state about medicaid suspension in Arkansas
Expert:  Zachary replied 1 year ago.
If the state medical board asks about whether the physician has ever had any problem with medicaid, then yes.

If not, as long as the suspension also did not result in a criminal charge, then no.
Customer: replied 1 year ago.
What if I answer no to state board , what actions can be taken if found out ? Also is it necessary to inform the employer and another state medicaid dept.?
Expert:  Zachary replied 1 year ago.
If you answer no, and perpetrate a fraud on the state board, you could have your licensed revoked, which would prevent you from practicing in any other state. Also, it could be prosecuted as a criminal act (lying on an application for a medical license is generally a felony).

It is not necessary to inform the employer nor the state medicaid department unless they specifically ask.

If you do not tell the employer, and they find out, you would not be subject to any criminal penalty.
Customer: replied 1 year ago.
I already have medical license and medicaid number for another state. Is it my duty to inform state board and medicaid depth of that state if I get hired ? What are the penalties if I donot inform medicaid and state board of that state . What happens if Arkansas medicaid finds out about me working in another state ? Also are they any written rules that I can follow to make sure I am doing correctly .
Expert:  Zachary replied 1 year ago.
Thank you for your response.

You do not have to report to the state medical board generally. Your right to practice medicine has not been revoked, only your ability to charge medicaid. You may continue practicing medicine in any state in which you are licensed.

However, 42 CFR 424.535 states that within 30 days of an adverse legal action, you would need to report to CMS.

Generally, the rules in 42 CFR 424, Subpart P - Requirements for Establishing and Maintaining Medicare Billing Privileges should be followed to ensure you are doing this correctly.
Customer: replied 1 year ago.
Thanks for all the information. I understand that I donot have to inform another state medicaid dept. but if they find out that my medicaid is temp. suspended in Arkansas , is there any penalty for that ?
Also if Arkansas medicaid finds out that I am working for medicaid in another state , is there any penalty?
Expert:  Zachary replied 1 year ago.
Let me be clear with you. If you go to another state and start billing medicaid without first alerting CMS that your privileges was revoked in Arkansas, you are going to violate the CFRs.

Each state would have its own penalty for any fraudulent behavior.

Given that the CMS statutes require notification to CMS, it is highly likely that CMS will revoke your billing privileges in general.

If you submit a bill to Medicaid but it is later not covered because your billing privileges have been suspended by CMS, then you will be liable for the cost of the services you provided.

You will also be subject to criminal penalties.
Zachary, Lawyer
Category: Employment Law
Satisfied Customers: 3927
Experience: Contracts, Wrongful termination and discrimination
Zachary and other Employment Law Specialists are ready to help you
Expert:  Zachary replied 1 year ago.
Please let me know if you have any further questions. Please also kindly consider rating my answer positively so that I am compensated by the website for my work on your question. Rating positively does not cause an additional charge and does not prevent us from further discussing your questions.

Best Regards,
ZDN
Zachary, Lawyer
Category: Employment Law
Satisfied Customers: 3927
Experience: Contracts, Wrongful termination and discrimination
Zachary and other Employment Law Specialists are ready to help you

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