Medicaid exclusion screening requirements in Florida
What Florida 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.
Content review and source verification
- Last reviewed
- Last verified
- Content owner
- Exclia content team
- Review cadence
- Every 90 days
- Next review due
What Exclia screens for this state
Florida’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
Check Florida’s action records and verify the current participation restriction.
Florida Statutes § 409.913(37) requires publication of provider sanctions or for-cause actions and specified affiliates. Its monthly publication rule does not establish a universal monthly employer screening interval. Review the requirements applicable to your provider agreement and managed-care contracts, alongside federal and other relevant state checks.
- Florida Statutes § 409.913 — Medicaid program integrity (2025 published edition)
- AHCA Public Record Search — Medicaid Sanctioned Providers
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
Medicaid Sanctioned Providers
Florida keeps its own Medicaid exclusion list, separate from the federal OIG list. Searching one does not cover the other.
AHCA’s Public Record Search includes a Medicaid Sanctioned Providers filter. Read the underlying order and verify its current effect; a historical order alone does not establish present participation status.
- Published by
- Florida Agency for Health Care Administration (AHCA)
- Refreshed
- At least monthly under Florida Statutes § 409.913(37); latest portal refresh not verified, per the publishing agency.
What happens if it is not done
The payment consequence depends on the participation restriction and the person’s role in the services.
- Section 409.913(25)(b) addresses denial or repayment for services furnished, supervised, or caused to be furnished by a person suspended or terminated from Medicaid or Medicare by a federal or state authority.
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.
Section 409.913(14) addresses Florida action following federal or another state’s participation restriction. Verify the agency decision and its continuing effect.
Common questions
Open AHCA’s Public Record Search, choose Legal Orders and select Medicaid Sanctioned Providers. Search relevant names and case identifiers, then read the linked order and document your verification.
No. AHCA’s explanation describes sanctions ranging from corrective measures and fines to suspension or termination. It also distinguishes for-cause actions from voluntary or contractual terminations without cause. Resolve the specific action with AHCA before making a participation decision.
No. AHCA warns that appeals can affect final disposition and that emergency restrictions may have been lifted. Sanctions before July 1, 2009 did not always generate a final order; ask AHCA about historical records when needed.
Check the current coverage page. A state guide or an official public portal does not mean Exclia has activated that source. Florida’s complete automated roster retrieval is not yet verified; no Florida data refresh date is claimed here.
The cited monthly rule concerns AHCA’s publication schedule. Set your screening interval from your applicable provider agreements, program guidance and contracts; this guide does not assert a universal Florida interval.
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.