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Alert to Florida Providers Regarding Screening

Line-drawing illustration of the Florida state flag, flower, and bird

Florida Agency for Health Care Administration (AHCA) and Office of Inspector General maintains the Florida Medicaid Suspended Providers and Sanctioned Providers Lists — a separate Medicaid exclusion list providers must screen alongside the federal OIG LEIE and GSA/SAM. Hiring or contracting with anyone on these lists creates federal penalty exposure, even when the hire was unintentional.

Florida at a glance

Official list nameFlorida Medicaid Suspended Providers and Sanctioned Providers Lists
Administering agencyFlorida Agency for Health Care Administration (AHCA) and Office of Inspector General
FormatOnline searchable list
Screening cadenceMonthly (CMS SMDL #08-003 and #09-001)
Official sourceView Florida’s official list →

Recent cases from across Florida

Each settlement below started with one missed exclusion check. All were preventable. Don’t let your organization become the next example.

October 2025 · Florida · Hospital

$18.85M — A hospital settled with OIG for employing an excluded individual (self-disclosed). Read the OIG settlement →

July 2025 · Florida · Medical practice

$25,756 — A medical practice settled with OIG for employing an excluded individual. Read the OIG settlement →

January 2025 · Florida · Medical practice

$41,740 — A medical practice settled with OIG for employing an excluded individual. Read the OIG settlement →

April 2024 · Florida · Medical practice

$69,772 — A medical practice settled with OIG for employing an excluded individual (self-disclosed). Read the OIG settlement →

July 2023 · Florida · Hospital

$117,724 — A hospital settled with OIG for employing an excluded individual (self-disclosed). Read the OIG settlement →

March 2023 · Florida · Medical practice

$67,207 — A medical practice settled with OIG for employing an excluded individual. Read the OIG settlement →

The pattern is clear: Organizations of all types and sizes can be penalized for hiring excluded people or vendors. The only reliable defense is screening every employee and contractor against every exclusion list, monthly. We make that easy for you.


I.  Florida’s State Exclusion. Excluded Providers Costs OIG Over 2.7 Million

The Office of the Inspector General (OIG) recently released a study on a subset of Florida’s Medicaid payments for pharmaceutical items. The study showed that in 2009 and 2010 the State agency made $180,000 in payments for pharmaceutical items prescribed by excluded providers. OIG, comparing this number to the total number of pharmacy payments, concluded that the State agency may have paid up to $2.7 million for items that excluded providers had prescribed.[1]

OIG concluded that these over-payments occurred because the State agency did not have proper policies in place to conduct prepayment review. Specifically, the agency had not established sufficient prepayment controls to ensure that valid provider IDs were on every pharmacy claim, and that the prescribing provider identification numbers were valid before making payments.

II.  Monthly Exclusion Screening Is Essential to Maintaining Effective Compliance Programs

Furthermore, the State agency was only conducting periodic searches of the LEIE and the GSA-SAM, which are maintained by OIG and CMS, respectively. This serves as just another reminder to providers that exclusion searches, in order to be effective, must be conducted monthly and must include searches of the LEIE, the GSA-SAM, and all 41 state Medicaid lists. Failure to search every list creates a hole in your screening process and allows excluded individuals to continue billing to the Federal health care programs.

Florida has since created its own suspended provider list like a majority of the states. In addition to building this new system, it also refunded the Federal health care programs in the amount of $99,568. That expense could have been avoided with thorough monthly exclusion checks.

III. Conclusion

All providers must conduct monthly exclusion screening on the LEIE, GSA-SAM, and all 41 state Medicaid lists. OIG is aggressively cracking down on providers who employ excluded individuals and will impose Civil Monetary Penalties (CMPs) of up to $10,000 for each item or service billed to the Federal health care programs that was provided directly or indirectly by an excluded individual.

Click here to read more on State Exclusions.   Call us at 1-800-294-0952 or fill out the form below to find out how Exclusion Screening can help you with your Florida Exclusion Screening requirements and a free quote and assessment.

Florida's State Exclusion 

Ashley Hudson, Associate Attorney at Liles Parker, LLP and former Chief Operating Officer for Exclusion Screening, LLC, is the author of this article. Feel free to contact us at 1-800-294-0952 or online for a free consultation.


[1] Lori S. Pilcher, Florida Made Some Payments for Pharmacy Items That Excluded Providers Had Prescribed, Dep’t of Health and Human Servs., Office of the Ins. Gen., 3 (June 2014).

Related Resources

State Databases

Map of all states with separate Medicaid exclusion lists we screen against.

View state map →

Exclusion Screening

Screen employees and providers against over 42 federal and state exclusion databases.

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Glossary

Definitions of key healthcare compliance terms like OIG, LEIE, and SAM.

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