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Montana Exclusions

Search the Montana Medicaid Excluded and Terminated Providers List, OIG Exclusions, SAM.gov, and all State Medicaid Exclusion lists at once to make Exclusion Screening easier.

HealthProviders DB is a nationwide database featuring over 9 million healthcare provider profiles—including the complete NPI database, OIG Exclusions, SAM Exclusions, CMS Revoked Medicare Providers, and all State Medicaid Sanctions, Suspensions, Terminations, and Exclusion lists, updated daily!

Enter an NPI number, license number, or provider name in the search field below to search Montana exclusions.

Alternatively, you can also search all Exclusions and the Healthcare Provider Profiles.

Montana Exclusion Screening Requirements

Providers excluded by the OIG or terminated by a State Medicaid Agency cannot participate in federally funded healthcare programs. This includes Medicaid, TRICARE, and the Children’s Health Insurance Program (CHIP). Additionally, the Centers for Medicare & Medicaid Services (CMS) can revoke billing privileges, prohibiting the provider from participating in Medicare.

The Montana Department of Public Health & Human Services (DPHHS) is responsible for identifying, preventing, and prosecuting fraud, abuse, and misuse in the public healthcare programs.

Providers must screen both current employees and new hires for exclusions from participating in the Medicaid program, and may face Civil Monetary Penalties (CMP) if they fail to ensure that proper exclusion screening has been conducted.

In addition, providers are liable for overpayments made for any items or services provided by any excluded person for which the provider received reimbursement from federal healthcare programs.

Save Time & Money, we can help you with Exclusions Screening

Non-compliance can be severe!

  • Required repayment of claims.
  • Costly Civil Monetary Penalties.
  • Loss of access to federally funded healthcare programs.
A short video on how to run Exclusions Screening

Just $25 / 100 Providers Screened

No registration or user account required

Benefits of Exclusions Screening

Features

Screen all your healthcare providers, employees, vendors, and contractors at once for:

Includes Primary Source Exclusion Verification Tools.

How Exclusions Screening Works

Step One: To use our Batch Exclusion Screening service, upload your list of NPI numbers in either Excel or text format.

Step Two: Provide your email to receive a link to the Exclusions Report, and then click Start.

Step Three: Click the download report link in the email to open the payment page. The price is based on the number of providers uploaded and screened.

The Exclusions Report automatically downloads after payment.

Audit-ready Exclusions Report

The report includes complete details about the provider and the reasons for the exclusions. Along with links to the primary source of the exclusion for verification on the federal or state agency website.

Comprehensive Exclusions Report

  • Full Name, First, Middle, and Last Names.
  • Full Address, Address 1, Address 2, City, State, and Zip.
  • NPI Number and NPI Deactivated Date.
  • License Numbers, Active Status, and Expiration Date.
  • Medicare Opt Out Affidavit Start and End Dates.
  • Exclusion Date, Reason, and Reinstatement Date.
  • Exclusion Status of Clear, Exact, Possible, Reinstated, Deactivated, Opted-out.
  • OIG, SAM, or State reporting Agency Details.
  • Plus, links to the Exclusion Source Data and Verification Page.
Sample Batch Exclusions Report

Download Sample Report

Frequently Asked Questions

Why is Exclusion Screening Essential?

Requirement
Federal database checks—42 CFR Part § 455.436 requires all Medicare Advantage Plans, all State Medicaid Programs, and all Medicaid Managed Care Organizations to confirm through routine Federal database checks the exclusion status of providers.

Compliance
The Office of Inspector General (OIG) mandates screening to prevent fraud, abuse, and patient neglect.

Financial Risk
Hiring an excluded individual can result in substantial Civil Monetary Penalties (CMPs) and repayment obligations.

How often should Exclusion Screening be done?

According to the OIG’s Special Advisory Bulletin issued in May 2013, the OIG recommends that healthcare organizations check their employees and contractors against the LEIE monthly.

42 CFR Part § 455.436(c)(2) Federal database checks states to “check the LEIE and SAM no less frequently than monthly.”

Monthly screening is mandatory in at least 14 States, while many others strongly recommend that providers screen employees and vendors against their State lists and the LEIE monthly.

Who should be screened for Exclusions?

Healthcare organizations must conduct exclusion screening for all individuals and entities that provide items or services payable by federal health care programs.

This requirement applies to anyone whose work supports services reimbursed by Medicare or Medicaid—whether those services are provided directly or indirectly.

Healthcare Providers & Facilities
Hospitals, nursing homes, home health agencies, clinics, and physician practices.

Personnel
All employees (clinical and non-clinical), pharmacists, pharmacy staff, physicians, nurses, clinical staff, medical assistants, and administrative staff.

Contractors & Vendors
Third-party billing & coding services, transportation providers, ambulance services, and medical equipment suppliers.

Leadership & Support
Board members, managers, owners, and volunteers.

Basically, if an individual’s role contributes in any way to federally reimbursable services, that individual should be included in your OIG exclusion screening and Medicare exclusion monitoring process.

Furthermore, the OIG has emphasized that civil monetary penalties are most likely when excluded individuals provide essential services to patient care.

Learn more about who needs to be screened for Medicare Exclusion.

How to automatically screen providers monthly?

HealthProviders DB offers automated, continuous exclusion monitoring subscriptions.

Features Include:
✓ Manage your list of all healthcare providers, employees, vendors, and contractors that are continually being monitored.
✓ Monthly OIG ExclusionsSAM Exclusions, & all State Medicare Exclusions Lists updates.
✓ Comprehensive and audit-ready Exclusions Report.
✓ Automatic Exclusions Change Notifications.
✓ Detailed Exclusions Dashboard with total Providers, Exclusions, Verifications, Reinstatements, Medicare Out-of, and NPI deactivations.
✓ Primary Source Exclusion Verification Tools.
✓ The ability to Save Notes & Documented Evidence of Exclusion Screening.

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