Medicaid exclusion screening requirements in Delaware
What Delaware Medicaid requires of the organizations that take part in it: whether the state keeps its own exclusion list, how often it expects you to check, what the penalties are, and how an action taken in another state reaches you here. Every claim on this page links to the source it came from.
What Exclia screens for this state
Delaware’s own Medicaid exclusion list is rolling out to Exclia. The federal lists (OIG LEIE and SAM.gov) are screened today.
What the state requires
Verify identity, authority and current participation status with the publisher.
The report includes reprimands, active providers, historical reinstatements and conflicting dates. It does not establish a statewide screening frequency or a reliable current exclusion predicate.
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 state’s own list
Delaware Sanctioned Provider Report
Delaware keeps its own Medicaid exclusion list, separate from the federal OIG list. Searching one does not cover the other.
The complete report dated September 11, 2026 contains historical sanctions from multiple authorities, effective dates, reinstated dates and comments. Membership alone does not establish a current Medicaid exclusion.
- Published by
- Delaware Health and Social Services — Delaware Medical Assistance Program
- Refreshed
- Not stated by the reviewed dated report., per the publishing agency.
How Exclia reads this list
Exclia reads the Delaware Medical Assistance Program provider report (PDF).
The report mixes historical actions and reinstatements without a stated current status, so Exclia stores every row as evidence but screens none of them until the publisher confirms what is current.
Whether this source is screening today, and the exact file version in use, is shown on the coverage page.
What happens if it is not done
The report combines historical participation and professional-regulation actions.
- Medicaid sanctions, OIG labels and licensing actions are separate authority evidence. A sanction or termination is not automatically a procurement debarment; a dated reinstatement or elapsed period does not prove current program eligibility.
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.
How another state’s action reaches you here
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.
Common questions
No. The official report includes active providers and historical reprimands, probation, termination and reinstatement evidence. Current eligibility remains unresolved until authoritative interpretation is reviewed.
No. Live coverage requires actual enabled collection, reviewed terms, immutable activation and retrieval metadata. This source is quarantined and the guide remains pending counsel review.
Check one name against the federal lists, free
One name, no account, and the result states which sources it covered and which it did not. It is a spot check rather than monitoring — it does not satisfy a monthly requirement on its own.
Run a free checkOr do it for the whole roster, every month
Exclia screens every person and vendor on your roster each month against the sources we cover, and keeps the dated audit trail that shows you did it.
See pricingEvery published state in one printable table, with the source for each row and a publication date you can check. Get the state-by-state requirements table
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.