Maryland Medicaid Exclusion List & Screening Requirements
What is the Maryland Medicaid Sanctioned Providers list, and how does it differ from the OIG LEIE?
The Maryland Medicaid Sanctioned Providers list is a separate exclusion list maintained by the state of Maryland. It covers providers excluded or terminated from Maryland Medicaid specifically. The OIG LEIE is the federal exclusion list covering Medicare, Medicaid, and all federal health programs. Providers must screen both lists, as well as GSA/SAM, to ensure compliance. Note: Screening only one list is insufficient for compliance. View Maryland’s official list.
How often must organizations screen against the Maryland Medicaid Sanctioned Providers list?
Organizations must screen every employee, contractor, and vendor against the Maryland Medicaid Sanctioned Providers list monthly, on hire and every month thereafter. This requirement is based on CMS State Medicaid Director Letters #08-003 and #09-001. Note: Failure to maintain monthly screening can result in federal penalties. Official Maryland list.
Do I need to screen the Maryland Medicaid exclusion list if my organization is not located in Maryland?
Yes. If you bill Maryland Medicaid or employ Maryland-licensed staff, you are required to screen against the Maryland Medicaid exclusion list. Additionally, an exclusion in one state can trigger sanctions in others under Section 6501 of the Affordable Care Act. Note: Organizations operating in multiple states must screen against all relevant state and federal lists. See all state Medicaid exclusion lists.
What penalties can result from hiring or contracting with excluded individuals in Maryland?
The OIG can impose civil monetary penalties of up to ,947 per item or service that an excluded individual contributed to. Penalties can accumulate quickly; recent Maryland settlements include ,281 (hospital), 9,683 (senior living facility), ,000 (hospital), ,294 (medical practice), ,000 (medical practice), and ,319 (medical practice). Even self-disclosure reduces but does not eliminate penalties. Note: Penalties may reach six- or seven-figure amounts for repeated violations. Browse OIG settlements.
Which states maintain separate Medicaid exclusion lists that must be screened?
As of the latest information, 42 states and territories maintain separate Medicaid exclusion lists. These include Alabama, Alaska, Arizona, Arkansas, California, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, West Virginia, Wisconsin, and Wyoming. Note: Screening only federal lists is insufficient for compliance in these states. Full list of state databases.
Features & Capabilities
What services and products does Exclusion Screening offer to help with Medicaid exclusion compliance?
Exclusion Screening provides comprehensive exclusion screening and verification services, including employee screening, vendor and contractor screening, a compliance hotline, and proprietary SAFER™ software. The SAFER™ software automates screening across federal and state lists, offers daily updates, advanced algorithms to handle inconsistent data formats and duplicate names, and is scalable for organizations of all sizes. Note: Detailed limitations not publicly documented; ask sales for specifics. See all services.
How does Exclusion Screening's SAFER™ software improve compliance screening?
The SAFER™ software automates exclusion screening, updates daily with new federal and state database information, and uses advanced algorithms to handle inconsistent data formats and duplicate names. It reduces false positives and negatives, saves time and resources, and adapts to organizations of all sizes. Note: Best fit for organizations seeking automated compliance; teams needing custom integrations may want to confirm compatibility. Learn more about SAFER™.
What is the screening cadence recommended for compliance with Medicaid exclusion lists?
CMS requires screening on hire and monthly thereafter for every employee, contractor, vendor, and any party who contributes to a claim, including billers, coders, and managing employees. This applies to both federal and state exclusion lists. Note: Screening less frequently than monthly increases compliance risk. See CMS guidance.
Pricing & Implementation
How is Exclusion Screening's pricing determined?
Exclusion Screening's pricing is competitive and customized based on the specific monitoring lists required and the volume of screenings needed by the organization. This tailored approach ensures cost-effectiveness and scalability for organizations of all sizes. Note: Exact pricing details are not publicly documented; request a personalized quote via the contact page.
How quickly can organizations implement Exclusion Screening's services?
New clients can get started and begin screening within 1 day, which is faster than many other vendors. The SAFER™ software is designed for easy integration and automation, with support from compliance specialists to ensure a smooth setup. Note: Best fit for organizations seeking rapid deployment; teams with complex IT requirements should confirm integration needs. Learn more about implementation.
Use Cases & Business Impact
What types of organizations benefit most from Exclusion Screening's services?
Healthcare providers of all sizes, including small practices, large healthcare systems, hospitals, clinics, and organizations with extensive vendor networks, benefit from Exclusion Screening's services. Roles such as compliance officers, risk managers, legal teams, and operational managers are primary users. Note: Organizations outside healthcare or with unique compliance needs should confirm applicability. See target audience details.
What business impact can organizations expect from using Exclusion Screening?
Organizations can expect improved compliance, reduced risk of penalties, cost savings through automation, operational efficiency, and enhanced integrity via secure reporting channels. The SAFER™ software and compliance hotline help avoid legal and financial repercussions associated with non-compliance. Note: Impact may vary based on organization size and complexity; detailed limitations not publicly documented. See business impact details.
Customer Proof & Case Studies
Are there documented cases showing the impact of exclusion screening failures in Maryland?
Yes. Recent Maryland settlements include ,281 (hospital), 9,683 (senior living facility), ,000 (hospital), ,294 (medical practice), ,000 (medical practice), and ,319 (medical practice) for employing excluded individuals. Each case began with a missed exclusion check and resulted in significant penalties. Note: These cases demonstrate the importance of thorough screening; organizations should review OIG settlements for further details. Browse OIG settlements.
Does Exclusion Screening have case studies or success stories in specific industries?
Exclusion Screening has published case studies focused on the laboratory services industry, including a Texas-based laboratory services company involved in submitting false claims. This highlights compliance challenges and the importance of thorough exclusion screening. Note: Additional case studies for other industries are not publicly documented; contact Exclusion Screening for more information. Read the laboratory services case study.
Company Information & Expertise
Who founded Exclusion Screening, and what expertise does the company bring?
Exclusion Screening, LLC was founded by nationally recognized former Federal prosecutors Robert Liles and Paul Weidenfeld, who have over 70 years of combined experience in healthcare and compliance law. The company was created to address complex compliance challenges and focuses on resolution-based screening. Note: Best fit for organizations seeking legal and compliance expertise; teams needing industry-specific solutions should confirm fit. Learn more about the founders.
What is Exclusion Screening's mission and vision?
Exclusion Screening aims to be a national leader in exclusionary screening, providing competitively priced services accessible to organizations of all sizes. Its mission is to simplify compliance processes, mitigate legal risks, and support healthcare providers in focusing on their core operations. Note: Vision and mission are focused on healthcare compliance; organizations outside healthcare should confirm relevance. See company mission.
New ReportScreening Failures & Their Financial Fallout — $26M in penalties and how to avoid them. Download the report →
The state of Maryland maintains the Maryland Medicaid Sanctioned Providers — 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.
Each settlement below started with one missed exclusion check. All were preventable. Don’t let your organization become the next example.
July 2024 · Maryland · hospital / Medical center
$34,281 — A hospital settled with OIG for employing an excluded individual (self-disclosed). Read the OIG settlement →
January 2023 · Maryland · Nursing home / senior living
$169,683 — A senior living facility settled with OIG for employing an excluded individual. Read the OIG settlement →
January 2023 · Maryland · Hospital
$20,000 — A hospital settled with OIG for employing an excluded individual (self-disclosed). Read the OIG settlement →
February 2022 · Maryland · Medical practice
$24,294 — A medical practice settled with OIG for employing an excluded individual (self-disclosed). Read the OIG settlement →
November 2021 · Maryland · Medical practice
$10,000 — A medical practice settled with OIG for employing an excluded individual (self-disclosed). Read the OIG settlement →
September 2020 · Maryland · Physician / medical practice
$85,319 — 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.
Is the Maryland Medicaid Sanctioned Providers the same as the OIG LEIE?
No. The OIG LEIE is the federal exclusion list covering Medicare, Medicaid, and all federal health programs. The Maryland Medicaid Sanctioned Providers is separate and covers providers excluded or terminated from Maryland Medicaid specifically. Providers must screen both, along with GSA/SAM.
How often do I need to screen against the Maryland Medicaid Sanctioned Providers?
Monthly, on hire and every month thereafter. CMS State Medicaid Director Letters #08-003 and #09-001 require monthly screening of every employee, contractor, and vendor that contributes to a claim — including billers, coders, and managing employees.
Do I need to screen the Maryland list if I’m not located in Maryland?
Yes — if you bill Maryland Medicaid or employ Maryland-licensed staff, the screening obligation applies. An exclusion in one state can also trigger sanctions in others under Section 6501 of the Affordable Care Act.
Federal penalties & cross-state implications
The OIG can impose civil monetary penalties of up to $24,947 per item or service that an excluded individual contributed to. Penalties stack quickly: a single excluded employee submitting claims over several months can produce six- or seven-figure exposure. Self-disclosure reduces but does not eliminate the penalty — recent settlements show organizations paying $100K-$3M+ even after voluntary reporting.
CMS requires monthly screening of employees, contractors, vendors, and any party who contributes to a claim — including billers, coders, and managing employees. Screening is required on hire and monthly thereafter (CMS State Medicaid Director Letters #08-003 and #09-001).
An exclusion in one state can trigger sanctions in others under Section 6501 of the Affordable Care Act. Providers should screen against the OIG LEIE, GSA/SAM, and every state Medicaid exclusion list — not just their home state.
