Medicaid exclusion screening requirements in Indiana
What Indiana 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 Indiana FSSA Provider Terminations — last refreshed Oct 15, 2026, 14:23 UTC.
Updated quarterly at the source.List version in use: 2c5444ec-18f9-4860-8765-876ec632527aWhat the state requires
FSSA publishes terminations because federal rules require notice — not as a screening list.
FSSA explains that federal regulation requires states to give notice when a Medicaid provider’s enrollment is terminated for cause, and the list is that notice. It sets no screening frequency and describes the list as informational. Use it together with the federal OIG list and SAM.gov, and with the re-enrollments list, rather than on its own.
- Termination of Provider Participation in Medicaid and CHIP — Indiana FSSA
- 42 CFR 455.416 — Termination or denial of enrollment
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
Provider Terminations
Indiana keeps its own Medicaid exclusion list, separate from the federal OIG list. Searching one does not cover the other.
FSSA’s list of historical and current “for cause” terminations of Medicaid and CHIP provider enrollment, published as a workbook with a separate list of re-enrolled providers. FSSA states that it is not an active or ongoing exclusionary list and is intended for informational purposes.
- Published by
- Indiana Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning
- Refreshed
- Not stated by FSSA; the workbook is dated in its title, per the publishing agency.
What happens if it is not done
FSSA lists conduct that meets the federal definition of a “for cause” termination; the list is not exhaustive.
- Examples FSSA gives: adverse licensure actions, federal exclusion, fraudulent conduct, abuse of billing privileges, misuse of a billing number, falsified enrollment information and falsified medical records.
- A provider terminated on or after January 1, 2011 by Medicare, or by the Medicaid program or CHIP of any other state, must be denied enrollment or terminated (42 CFR 455.416(c)), so a termination elsewhere can follow a provider to Indiana.
- A provider who re-enrolls is published on a separate re-enrollments list and may still appear on the termination workbook, so read the two together.
- Termination of Provider Participation in Medicaid and CHIP — Indiana FSSA
- 42 CFR 455.416 — Termination or denial of enrollment
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
Not as such. FSSA publishes a list of for-cause terminations of Medicaid and CHIP enrollment and states that it is not an active or ongoing exclusionary list. It is still worth checking, because a for-cause termination ends a provider’s Indiana Medicaid enrollment.
Conduct that meets the federal definition, such as adverse licensure actions, federal exclusion, fraudulent conduct, abuse of billing privileges, misuse of a billing number, or falsified enrollment information or medical records. FSSA’s list of examples is not exhaustive.
FSSA publishes re-enrolled providers separately, and a re-enrolled provider can remain on the termination workbook. Check whether the NPI appears on the re-enrollments list with a later date before treating a termination as current.
FSSA does not state an interval. For the federal list, the HHS Office of Inspector General describes monthly screening of its federal list as the approach that best limits liability; confirm any state requirement in your provider agreement or contract.
Exclia imports the workbook dated July 2026 (112 rows) with the re-enrollments list joined, parsed on October 15, 2026. A re-enrolled provider is kept but never shown as a match, and any other name on the list is a potential match for your team to 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 everyone you monitor, every month
Exclia screens every person and vendor you monitor 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.