Federal law is unambiguous: if you submit a Medicaid claim for a service provided by an excluded individual, you are liable for that payment regardless of whether you knew about the exclusion. Monthly screening is the only protection.
"No federal healthcare program payment may be made for any item or service furnished, ordered, or prescribed by an excluded individual or entity." This obligation applies to every caregiver on your roster, including self-directed family caregivers enrolled through Medicaid waiver programs.
83,000+ excluded individuals, updated monthly, name/NPI/phonetic fuzzy matching.
Federal debarment and suspension list, required for all federal program participants.
Georgia DCH state exclusion list cross-reference for MCO-enrolled providers.
Every screening engagement produces a branded Prognosis Consulting compliance certificate documenting screening date, roster size, database versions used, and findings. Appropriate for OIG audit response, MCO credentialing requests, and internal compliance files.
Submit a screening request and we will confirm scope, pricing tier, and secure roster submission instructions within one business day.