Medicaid exclusion screening requirements in Vermont
What Vermont 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 Vermont Medicaid Monthly List of For Cause Exclusions — last refreshed Oct 5, 2026, 10:28 UTC.
Updated monthly at the source.List version in use: 49a3754d-0c17-4265-8358-301b5db22d21What the state requires
Monthly publication does not establish a universal screening interval.
The workbook states that it is not comprehensive and that actions by other federal or state bodies may also apply. Consult applicable provider manuals, program rules and contracts; federal results do not establish state-list coverage.
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
Vermont Monthly List of For Cause Exclusions
Vermont keeps its own Medicaid exclusion list, separate from the federal OIG list. Searching one does not cover the other.
DVHA publishes one current workbook of providers removed from Vermont Medicaid participation for cause, with the reason, effective date and any reinstatement date. Exclia imports that workbook.
- Published by
- Vermont Department of Vermont Health Access (DVHA)
- Refreshed
- Monthly (the workbook title names the month; the portal keeps a monthly upload history), per the publishing agency.
How Exclia reads this list
Exclia reads the monthly Excel workbook on the Vermont Medicaid provider portal.
Rows without a reinstatement date can produce a potential match. A row with a reinstatement date is stored as evidence and not reported as a potential match.
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
The workbook key says a listed provider stays off Vermont Medicaid until DVHA approves a reinstatement request.
- A reinstatement date means the period expired and DVHA granted reinstatement; no date means the action remains in effect.
- A matching name alone does not establish identity; the list publishes one unsplit name per provider.
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
Exclia has an importer for the official DVHA workbook. Its current status and freshness come from the coverage page; this guide does not claim activation. Rows with a reinstatement date are kept as evidence but are not reported as matches.
No. The workbook points to the Office of Professional Regulation and the Board of Medical Practice for professional discipline, and federal lists remain separate.
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.