Credentialing & Verification

State Medicaid Exclusion Check Automation

Check a provider against a state’s own Medicaid exclusion and sanction list: found or not-found status with the sanction type and dates, an evidence screenshot, and a timestamp, as one structured record. The state layer of exclusion screening, built state by state.

This workflowState Medicaid exclusion lists
StatusAvailable today
AccessBrowser agent
AuthPublic source

Overview

What this workflow does

Every state maintains its own Medicaid exclusion and sanction list, and it’s a genuinely different list from the federal ones: it carries state-level actions, exclusions, for-cause terminations, disbarments, that originate with the state’s own Medicaid program. A browser agent runs the check against the state’s official search: it enters the provider’s name, reads the results, and returns the same structured screening envelope as the OIG and SAM.gov checks, so all three layers of a screening program produce records in one shape.

The workflow is built per state, Louisiana today via the Louisiana Department of Health’s State Adverse Actions List search, and cloned state by state as coverage grows. A request for a state that isn’t built yet ends with a clear scoped error naming what’s supported, never a wrong answer dressed as a right one.

Step by step

How the check actually runs

  1. 01The agent opens the state’s official Medicaid exclusion and sanction search. For Louisiana that’s the LDH State Adverse Actions List, a public site with no login.
  2. 02It searches by the provider’s first and last name only. It never enters a Social Security Number, and never outputs one.
  3. 03It reads the results and classifies them: no matching record is a clean not-found; one match is found; several are multiple matches, with an NPI used to disambiguate when the list displays one.
  4. 04For every match it captures the listed name, the NPI if shown, the sanction type, exclusion, for-cause termination, disbarment, and the effective and reinstatement dates in ISO format.
  5. 05It screenshots the results as audit evidence, timestamps the check, and returns one structured record.

A not-found run is a successful clean check, on record with evidence, which is the thing an auditor actually asks for.

Structured output

What comes back

Every run ends as a record like this in your system, not a portal screenshot someone transcribes. This is the part your team stops doing by hand.

structured output · json
{
"source": "LDH State Adverse Actions List",
"status": "not_found",
"checked_at": "2026-07-16T14:02:11Z",
"result": {
"excluded": false,
"match_count": 0,
"matches": []
},
"evidence_screenshot_url": "https://…/evidence/run_2c91….png"
}

Your state’s list knows things the federal lists don’t

The OIG list covers federal healthcare-program exclusions and SAM.gov covers government-wide debarment, but a for-cause termination or a sanction from a state Medicaid program lives on the state’s own list, and it can sit there without a matching federal entry. That’s why screening guidance treats the state list as its own required layer rather than a redundancy. A monthly pass that runs the OIG check and the SAM.gov check but skips the state layer has a gap exactly where the most local, most recent findings appear.

At scale

One provider, or the monthly screening pass

A single run checks one provider against one state’s list. As a program, the roster runs monthly alongside the OIG and SAM.gov checks, three lists, one cadence, one record shape, and the exceptions land with your compliance team with the state’s own wording and a screenshot attached. Screening is part of the credentialing and verification workflow library. The same state source answers a different question in the DSW registry check.

Human in the loop

What escalates to a human

Each state check runs on HIPAA-compliant, SOC 2 Type II infrastructure with per-run logs, so the monthly cadence is demonstrable rather than asserted. See the security page.

Multiple matches on a common name.

All matches are reported with detail; a person confirms identity, with the NPI as the tiebreaker when the list shows one.

A found result.

A state sanction is an employment and billing decision. The agent delivers the record and the evidence; the call is yours.

A state that isn’t built yet.

A clear scoped error naming what’s supported, never a silently skipped check.

Questions

Frequently asked questions

Louisiana today, through the LDH State Adverse Actions List. The workflow is deliberately built to be cloned per state, and a request for an unsupported state fails with a clear scoped error rather than a wrong answer. If your roster spans specific states, scoping those builds is the fastest path to coverage.

The state Medicaid check is one workflow in the credentialing and verification workflow library. A screening pass that skips the state layer is a gap an auditor can find, and state auditors look at the state layer first.

Disclaimer

Third-party names, including government agencies and registries, are used only to identify systems commonly involved in healthcare operations workflows. Asteroid is not affiliated with, endorsed by, sponsored by, or certified by those third parties unless expressly stated. Workflow availability depends on customer authorization, account permissions, configuration, and applicable system terms.