Before any provider of medical services receives payment from the Rhode Island Medicaid program, and as a condition of receipt of payment, the provider must have in effect a valid certification of eligibility from the Rhode Island executive office of health and human services. This certification of eligibility will take the form of either a separate provider agreement or language as required by federal regulations imprinted on the medical assistance billing form, which must be signed by the provider. This certification may be revoked or suspended, in accordance with administrative rules to be promulgated by the executive office, if a provider fails to meet professional licensure requirements; violates any administrative regulations of the executive office of health and human services; does not provide proper professional services; is the subject of a suspension of payments order; is convicted of Medicaid fraud; or otherwise violates any provision of this chapter.