For Medicaid managed-care plans, Medicare Advantage / Part D sponsors and their first-tier and downstream entities
For health plans that must show the monthly exclusion check on providers, staff and FDRs — 42 CFR 438.610 and 422.503(b)(4)(vi).
A Medicaid plan may not knowingly hold a relationship with an excluded individual or entity; the state contract carries the monthly LEIE and SAM check down to the plan. An MA or Part D sponsor's compliance program is tested on the same check across employees, the governing body and every first-tier, downstream and related entity. What the check leaves behind is a date. The receipt is that date: what the HHS-OIG LEIE, SAM.gov Exclusions and the state Medicaid lists printed for each name, when — hashed, signed, and exportable as a Verifiable Credential the state or CMS auditor verifies without us.
The rule as written
42 CFR 438.610; 42 CFR 438.608(b); 42 CFR 438.602(d); 42 CFR 422.503(b)(4)(vi); 42 CFR 423.504(b)(4)(vi); 42 CFR 1001.1901
The MCO, PIHP, PAHP, PCCM or PCCM entity may not knowingly have a relationship with an individual or entity that is debarred, suspended, or otherwise excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in nonprocurement activities under regulations issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549 — as a director, officer, or partner; a person with beneficial ownership of 5 percent or more; an employment, consulting or other arrangement for the provision of items and services significant to the contract; or a network provider.
What the receipt shows
- HHS-OIG LEIE — the exclusion rows as printed for the exact name and NPI, or that the LEIE did not answer
- SAM.gov Exclusions — rows as printed for the exact name, or that SAM did not answer
- The state Medicaid exclusion/termination list for each state the plan operates in, as published
- The month-over-month difference, line by line, and every source that did not answer named — never counted as 'no record'
How it fits your workflow
- 1. One provider or employee
Enter the name, or the name with its NPI. One dated receipt across the LEIE, SAM and the state lists, free.
Pull a receipt - 2. The first 25 names
CSV in under a signed roster: one receipt per row, identical to the free one, within 48 hours of the order.
Upload the roster - 3. The network and the FDR list
The enterprise roster — every name re-read monthly, the diff, the export the auditor verifies without us. On invoice.
Enterprise roster - 4. Put it in the FDR agreement
Paste-ready language asking each first-tier and downstream entity for the dated read instead of an attestation.
Evidence Clause
Duty sheets and form lines
A Duty Sheet puts the dated record beside the rule's own question and builds a fresh receipt for the name you give it (sample: Wellpath LLC): 42 CFR 455.436 duty sheet (the state's monthly check) ↗.
The form lines these receipts are filed behind, with the auditor's test cited: 42 CFR 438.608 / 438.610 form line · 42 CFR 422.503(b)(4)(vi) FDR form line · 42 CFR 455 provider screening. Full forms register · read profiles · published prices.
Published price
One receipt is free. For the network, the staff list and the FDRs re-read monthly, on invoice: Enterprise roster — Medicaid managed-care plans, MA/Part D sponsors and their FDRs.
- Enterprise roster — to 1,000 names, re-read monthly, with the diff12 months, invoice$9,999
- Enterprise roster — to 5,000 names, re-read monthly, with the diff12 months, invoice$29,999
- Enterprise roster — above 5,000 names, by agreement12 months, invoiceon invoice
Every tier reads the same sources and prints the same receipt; price changes volume and cadence, never content. All published prices · Product page.
What it does not do
- We do not say a plan's compliance program is effective, that a contract term was met, or that a provider is eligible — those are the state's, CMS's and your judgments. The receipt prints the rows.
- A same-name row is shown, never counted as a match; the receipt does not establish identity.
- Your screening vendor keeps its workflow; this is the portable record of what the public files printed, verifiable without either of us.
Public-record evidence, not legal, compliance or eligibility advice. Hashes, signatures and timestamps prove the integrity of our capture; the agency remains the author of its record. When the agency did not answer · Who pays us.
Also: Government contractors · Counties, districts & grantees · Single-audit CPA firms · Law firms · Bond counsel · Lenders & title · Deal counsel