42 CFR § 455.436 — Federal database checks
42 CFR 455.436 monthly screening requirements
The State Medicaid agency must check the Social Security Administration's Death Master File, the National Plan and Provider Enumeration System (NPPES), the List of Excluded Individuals/Entities (LEIE), the Excluded Parties List System (EPLS) [now SAM.gov], and any such other databases as the Secretary may prescribe … (c)(2) Check the LEIE and EPLS no less frequently than monthly. source
Who it reaches
State Medicaid agencies directly; Medicaid managed-care plans and enrolled providers by contract and state provider agreement, which commonly pass the monthly LEIE/SAM cadence down to every provider and vendor.
The record the rule expects
For each name, each month: the LEIE file date and the SAM.gov read time, the exact name or NPI used, the rows printed (or none), and any source that did not answer that day. NPPES by NPI. The Death Master File is restricted and is not read here — say so on the record.
Free
Read one name now — every source, dated, hashed.
Free, once
500 names you already screened — the 48-hour comparison.
Sector receipt
/receipts/for/hospitals
Duty Sheet
One page per rule, generated on any receipt
Protocol template
Adopt it as yours; set every threshold
Questions readers ask
Does 455.436 apply to hospitals?
The section is addressed to the State Medicaid agency. Hospitals and other providers meet the same monthly cadence through their state provider agreement, their MCO contracts and the OIG's compliance program guidance, which is why the monthly roster check is standard practice.
Is a 'no results' line enough?
A line that cannot distinguish 'no row under this name' from 'the list could not be read today' is a gap an auditor will find. The record should show the source's own date and a did-not-answer state where that happened.
Which state lists?
The state's own Medicaid exclusion or termination list, where the state publishes one. This platform reads 15 state lists as held files; the others are listed as not read.
This page quotes the rule and describes the record; whether your organization meets the rule is your compliance office's and counsel's reading. All rules · Methodology.