The state-by-state exclusion screening requirements table
One page you can take to a compliance meeting: what each state’s Medicaid program asks of the organizations in it, and where the state publishes the requirement. Free, and sourced line by line.
What is in it
- A row per published state: whether it keeps its own Medicaid exclusion list, how often it expects you to check, and a link to where the state publishes the requirement.
- The federal requirements that apply in every state, stated once — the cross-state effect of ACA § 6501, the OIG’s monthly screening guidance, and the penalty exposure behind each state’s own consequences.
- A publication date and a changelog on the first page, so you can tell whether the copy in your files is still the current one.
- A source for every claim, so nothing in it has to be taken on our word.
This table is generated from the same state files the guide pages on exclia.com render, so the table and the pages cannot disagree.
Send me the table
We will email you the current edition as a PDF. Your address is stored so we can tell you when a new edition is published; nothing else, and you can ask us to remove it at any time.
What the table says
The 2026 State-by-State Exclusion Screening Requirements Table
Version 1 · Published Jul 30, 2026
3 of 42 states are published so far. A state joins this table once its requirements have been checked against the state’s own sources — a row of guesses would be worse than a short table.
Kentucky, New Jersey, Texas: our counsel has not yet reviewed this state’s entry. Every claim below links to the state’s own source, so you can check it yourself in the meantime.
| State | State exclusion list | How often the state expects a check |
|---|---|---|
| Kentucky(KY) | Terminated and Excluded Provider List | Monthly check expected |
| New Jersey(NJ) | NJ Ineligible Provider List | Monthly check expected |
| Texas(TX) | Texas HHSC OIG Exclusions Database | Monthly check expected |
The state’s own source for each row is printed beneath it, so you can check any claim here against the state’s own publication.
What applies in every state
These requirements do not vary by state, so they are stated once here rather than repeated in every row.
An action taken in another state does not stay there
Section 6501 of the Affordable Care Act (42 U.S.C. § 1396a(a)(39), implemented at 42 C.F.R. § 455.416(c)) requires a state Medicaid agency to deny or end the enrollment of any provider that was terminated for cause on or after January 1, 2011 under Medicare, or under the Medicaid or CHIP program of any other state, and that appears in the federal termination database. In practice that means an action taken against a provider in one state reaches their participation in every other — so the list that matters to you is not only your own state's.
Why monthly, and where the exposure comes from
The HHS Office of Inspector General publishes the federal exclusion list (the LEIE) monthly, and its guidance to providers is that screening staff and contractors each month is what best limits the risk of overpayment and civil monetary penalty liability. State Medicaid agencies are themselves required to check the LEIE no less frequently than monthly (42 C.F.R. § 455.436(c)(2)), which is the rhythm the lists move on.
The federal exposure behind the state requirement
Where a federal health care program pays for an item or service furnished, ordered, or prescribed by a person on an exclusion list, the OIG can seek repayment of what was paid, civil monetary penalties for each item or service claimed (a statutory $10,000, adjusted annually for inflation), and an assessment of up to three times the amount claimed. The standard is what the organization knew or should have known — which is why the date of your last check is the fact that matters.
This states what each state publishes and links to where it says it. It is not legal advice, and where your own obligations are unclear your counsel is the right reader of these sources.
Editions
Every edition of this table and what moved in it, newest first — so you can tell whether the copy you have is the current one.
Reviewed quarterly, and republished with a new version and a changelog entry whenever a state’s requirement or source changes. The version and date above are how you tell which edition you are holding.
Version 1 — 2026-07-30
- First publication, covering Kentucky, New Jersey, and Texas — the three states whose requirements have been checked against the state’s own sources so far.
- Added the federal requirements that apply in every state: the cross-state effect of ACA § 6501, the OIG’s monthly screening guidance, and the penalty exposure behind each state’s own consequences.
- All three states are published ahead of counsel review of their entries, so each row links to the state’s own source for you to check.
What else you can do
Read your own state in full
Each published state has a page with the provider-agreement wording, the penalties, what an action taken in another state means for you, and what Exclia currently screens for that state.
See the state guidesCheck one name against the federal lists, free
One name, no account. It is a spot check rather than monitoring — it does not satisfy a monthly requirement on its own.
Run a free checkThis table describes state requirements and names no person or organization. If you believe a public exclusion list holds something about you that is wrong, contact disputes@exclia.com: Exclia does not decide who appears on these lists and cannot change them, and we will tell you which agency publishes the list and how to reach it.