Medicaid exclusion screening requirements in Georgia
What Georgia 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
Exclia screens Georgia DCH OIG Exclusions List — last refreshed Oct 5, 2026, 10:07 UTC.
Updated monthly at the source.List version in use: 1c4a98fc-61d2-49e0-9387-8c343a8fc4c0What the state requires
Check the Georgia, federal OIG and SAM lists monthly and before starting a staff or contractor relationship.
DCH-OIG directs providers participating or applying to participate in Georgia Medicaid, including managed care entities, to search all three lists monthly for existing employees and contractors and before starting a staff or contractor relationship prospective staff. Providers must immediately report restriction information discovered among employees or contractors to DCH Provider Enrollment. A check of only one database does not cover all three.
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
Georgia OIG Exclusions List
Georgia keeps its own Medicaid exclusion list, separate from the federal OIG list. Searching one does not cover the other.
The state publishes a complete list of individuals and entities with Medicaid participation restrictions. Its workbook contains person and business names, provider category, state, sanction date and optional NPI. The page states that restrictions remain in effect until removal from the list.
- Published by
- Georgia Department of Community Health Office of Inspector General (DCH-OIG)
- Refreshed
- Updated at least monthly, according to DCH-OIG., per the publishing agency.
How Exclia reads this list
Exclia reads the complete Excel workbook from the Department of Community Health Office of Inspector General.
Every row is treated as a current action and keeps the workbook’s own sanction date.
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
Participation restrictions affect reimbursement for services.
- The publisher states that individuals and entities subject to these restrictions may not receive reimbursement for Medicare and Medicaid services in any category or capacity, including managed care.
- Restrictions remain effective until removal from the state list; an elapsed sanction period or a missing date does not establish reinstatement.
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
Yes. DCH-OIG provides a complete downloadable workbook, separate from the federal OIG LEIE and SAM. The page labels it XLS, while the verified October 2026 download is an XLSX workbook.
The official DCH-OIG page directs providers to search the Georgia, LEIE and SAM lists monthly and before starting a staff or contractor relationship, covering existing and prospective employees and contractors.
No. Some source rows have missing or inconsistent sanction dates, and some combine person and business names. Preserve the original evidence and confirm identity and status with DCH-OIG before making a participation decision; a name match alone is not a determination.
No. Current coverage depends on an enabled source, approved immutable list version and sufficiently recent retrieval shown by the coverage metadata. A published guide or downloaded fixture does not establish live coverage.
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.