Medicaid exclusion screening requirements in Maryland
What Maryland 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
Maryland’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
Confirm the published sanction and identity with Maryland.
The page directs readers to verify LB license status through the relevant Maryland State Board and to provide identifying information such as NPI, license type and number when verifying a listed provider. Monthly-if-needed describes list publication, not a cited monthly screening duty.
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
Maryland Medicaid Sanctioned Provider List
Maryland keeps its own Medicaid exclusion list, separate from the federal OIG list. Searching one does not cover the other.
The September 9, 2026 workbook mixes Medicaid sanctions, convictions and licensing-board discipline. An LB entry requires separate board verification and does not establish current Medicaid exclusion by itself.
- Published by
- Maryland Department of Health Medicaid
- Refreshed
- Monthly if needed, according to the publisher., per the publishing agency.
How Exclia reads this list
Exclia reads the Maryland Medicaid provider workbook (Excel), which mixes licensing-board and program actions.
Some rows carry action codes whose current meaning the publisher does not state. Exclia stores every row as evidence but screens none of them until those meanings are confirmed.
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
Maryland states that it suspends or excludes some providers from program participation.
- The workbook has mixed action codes. An elapsed date, missing row or board entry alone does not establish current eligibility or 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
No. LB covers suspended, surrendered or revoked licenses; the publisher requires board verification. Other codes describe sanctions or convictions, while OIG and LC are not explained in this workbook’s legend.
No production activation is claimed. Current coverage depends on enabled collection, approved immutable evidence and sufficiently recent retrieval shown on the coverage page; this guide and recorded workbook do 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.