Medicaid exclusion screening requirements in New Hampshire
What New Hampshire 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 NH Medicaid Provider Exclusion and Sanction List — last refreshed Oct 11, 2026, 04:05 UTC.
Updated monthly at the source.List version in use: 022cf38c-c4c9-4df8-b1eb-a2ac080f773dWhat the state requires
Use the state list as evidence and confirm current status with NH DHHS.
The reviewed page links the list without stating a screening interval or what a listing means for current participation. Check your provider agreement, managed care contracts and current agency guidance for your obligations.
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
NH Medicaid Provider Exclusion and Sanction List
New Hampshire keeps its own Medicaid exclusion list, separate from the federal OIG list. Searching one does not cover the other.
DHHS links an Excel workbook of individuals and businesses from its Medicaid Provider Relations page. Each row gives a provider or individual type, NPI where known, a free-text exclusion or sanction reason and an effective date. Reasons include Medicaid fraud convictions, licensing board actions, Medicare revocations and federal exclusions, and some rows are Medicaid recipients rather than providers.
- Published by
- New Hampshire Department of Health and Human Services
- Refreshed
- The workbook carries an "Updated" date (October 15, 2025 in the reviewed copy); the publisher does not state a fixed publication interval., per the publishing agency.
How Exclia reads this list
Exclia reads the NH Medicaid Provider Exclusion and Sanction List workbook (Excel).
Every listed row can produce a potential match, providers and Medicaid recipients alike. The published type and reason are kept with each row. The NH DHHS site does not allow automated downloads, so each new edition is uploaded by the Exclia team.
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
Listed reasons describe different actions with different consequences.
- A Medicaid fraud conviction, a licensing board action, a Medicare revocation and a federal exclusion are not interchangeable. Keep the published reason with the match.
- The list does not state removal or reinstatement. A row that later disappears is not, on its own, evidence of 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. The list mixes providers, their businesses and Medicaid recipients convicted of fraud, with reasons ranging from convictions to licensing board actions and Medicare revocations. Preserve the published type and reason rather than giving every row the same meaning.
Every listed row can produce a potential match, which your team reviews against the published type and reason. A match is a prompt for review, not a determination.
Yes. Exclia screens against the NH Medicaid Provider Exclusion and Sanction List. The coverage section at the top of this page shows the edition in use and when it was last retrieved, read live from Exclia’s coverage metadata. A name on the list is shown as a potential match for your team to review, never as a determination.
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.