Medicaid exclusion screening requirements in Montana
What Montana 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
Montana’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
Use Montana notices as potential-match evidence and check the federal OIG and SAM sources separately.
The publisher directs users to the OIG and SAM databases and warns against relying solely on this list to determine or verify provider enrollment or ability to provide services. The cited page does not state a universal monthly screening interval. Confirm identity, present participation status and applicable program requirements with DPHHS before making a decision.
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
Excluded or Terminated Montana Medicaid Providers
Montana keeps its own Medicaid exclusion list, separate from the federal OIG list. Searching one does not cover the other.
DPHHS publishes provider names, professions, optional NPI, effective dates and state or OIG action labels in a downloadable workbook. The publisher says this list is not all inclusive and must not be used alone to establish enrollment or ability to provide services.
- Published by
- Montana Department of Public Health and Human Services
- Refreshed
- No fixed publication interval stated on the cited page., per the publishing agency.
How Exclia reads this list
Exclia reads the Montana Medicaid participation actions workbook (Excel) from the Department of Public Health and Human Services.
This is a partial roster of actions, so it cannot confirm anyone’s enrollment status. Activation waits on a scope review.
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
Published actions concern Medicaid participation; current status requires agency verification.
- DPHHS publishes notices under ARM 37.85.507 and 42 CFR 1002.210, 1001.2005 and 1001.2006.
- An effective date or historical action label alone does not prove current enrollment, reinstatement or ability to provide services.
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
Follow the download link on the official DPHHS provider-notices page. The July 27, 2026 named XLSX was retrieved on October 4, 2026; check the publisher for a newer publication.
No. DPHHS expressly says the list is not all inclusive. Importing the entire published workbook preserves the publisher’s potential-match roster but cannot establish complete statewide coverage.
Explicit adjacent a.k.a. rows identify aliases of the preceding provider. Effective dates and OIG or State action labels are preserved as published evidence; no reinstatement or current enrollment status is inferred.
No. The official page directs users to separate OIG and SAM databases. The state publication does not establish coverage of either federal source.
A guide or successful isolated local import does not establish live coverage. Consult actual coverage metadata; scope and terms review plus approved first production activation remain required.
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.