Medicaid exclusion lists by state: LEIE, SAM.gov and the 51 state lists

The two federal lists first

LEIE download fields: LASTNAME, FIRSTNAME, MIDNAME, BUSNAME, GENERAL, SPECIALTY, UPIN, NPI, DOB, ADDRESS, CITY, STATE, ZIP CODE, EXCLTYPE, EXCLDATE, REINDATE, WAIVERDATE, WAIVERSTATE. The SAM.gov API returns 10 records per page and only the first 10,000 records in search mode; the extract mode delivers a CSV or JSON file by emailed link and “can return only the first 1,000,000 records”, which is more than the exclusion set holds. Rate limits run from 10 requests a day with no role to 1,000 a day with a personal or system account.

The SSN and EIN verification step

Neither federal file carries a taxpayer identification number. The OIG's own instructions say “The Privacy Act prohibits the distribution of SSNs so regardless of your exact process, you'll need to use the Online Search to verify specific individuals and entities”. In practice that means a two-step check: match names against the downloaded file (or an API) to find candidates, then confirm each candidate in the LEIE online search by entering the SSN or EIN from the W-9. A name hit with no TIN confirmation is a potential match, not an exclusion. The state lists have the same gap: none publishes a TIN, a few (Arizona, Montana, Tennessee) publish an NPI, and Louisiana and Pennsylvania let you verify a hit with an SSN or FEIN on their own search pages.

Exclusion, termination, suspension: why the list type matters

An exclusion bars the person or entity from payment by any federal health care program, directly or indirectly, for the stated period; federal exclusions appear on LEIE and most states add their own. A termination for cause ends a provider's enrollment in that state's Medicaid program; under section 6501 of the Affordable Care Act every other state must terminate the same provider, which is why termination lists matter beyond the state that publishes them. A payment suspension is a hold while a credible allegation of fraud is investigated and may end with no action. The lists mix these. Indiana's page is explicit that its terminated providers list “is not an active or ongoing exclusionary list” and the state relies on LEIE for exclusions; Missouri's is a termination list under 13 CSR 70-3.030 that the agency does not call an exclusion list; Louisiana's database holds everyone “sanctioned, which may include exclusions, for-cause terminations, or disbarment through LDH Health Standards”; Ohio's covers exclusions and suspensions but not licence-related terminations. The list type column records what the agency says its list is, so a hit can be read for what it means.

The state directory

Use the sort box above. Update frequency as stated is the agency's own wording; Not stated means the page gives a dated file but no schedule. Sources: each agency's program integrity or provider page, the list file where it could be downloaded, and search-engine confirmation of the page title and URL where the agency blocks automated access, all November 1, 2026.

Why a healthcare payer checks these before paying

Payment to an excluded party is not reimbursable by Medicare or Medicaid, and the OIG can impose civil monetary penalties on the entity that paid for items or services an excluded person furnished, ordered or directed. The exposure runs through vendors as well as clinicians: a billing company, a staffing agency, a pharmacy benefit contractor or a medical transport provider that employs an excluded person creates the same problem. Managed care contracts and state provider agreements pass the duty down, which is why the screen sits in the vendor file next to the W-9 and the TIN match rather than in the credentialing office alone. The healthcare industry page sets out the full provider record (TIN match, NPI, PECOS enrollment, exclusions, sanctions) and the 1099-MISC box 6 rule for medical payments, and the quarterly provider statement and oversight checklist is the template for the recurring review.

The order that works: LEIE and SAM.gov for everyone, then the state list for the state the payee is enrolled in and every state it serves, then Medicare enrollment where the payee bills Medicare. Repeat monthly; the OIG posts by the 10th, most states that state a cadence say monthly, and Pennsylvania's Medicheck site says it is updated daily.

Questions people ask