MedicaidAdministrativeHigh impact
Database of Texas Medicaid Excluded Providers Available on OIG Website
Texas Medicaid·TX·System Updates
We identified it
Jul 2, 2026
Summary
Texas Medicaid now requires all providers and applicants to screen employees and contractors monthly against the OIG exclusion database to maintain enrollment and revalidation eligibility. Texas Medicaid will deny claims involving excluded providers or their employees and will recover improperly paid funds. Providers must access the exclusion file from the Texas HHS OIG website and implement monthly screening procedures.
Action Required
Immediately: Billing team and credentialing staff must implement monthly screening process for all current employees, contractors, and new applicants against the Texas HHS OIG exclusion database (available at http://oig.hhs.texas.gov). (1) Designate staff responsibility for monthly download and review of exclusions file from the OIG website. (2) Cross-reference all active and new provider staff names against the exclusion list. (3) Document screening results and retention dates in compliance files. (4) Establish protocol to halt billing for any identified excluded individuals immediately and notify practice leadership. (5) Before enrollment, revalidation, or reenrollment with Texas Medicaid, confirm current month's screening is complete and documented. Failure to perform required screening will result in claim denials for any excluded providers/staff and potential recoupment of previously paid claims. This screening must occur every month to maintain Medicaid participation status.