Nc Medical Exclusions

Is this healthcare provider excluded from the North Carolina Medicaid program? Screens a person or business name, an NPI, and/or an atypical (non-NPI) Medicaid provider ID against NC Medicaid's (Division of Health Benefits, Office of Compliance and Program Integrity) State Excluded Providers List — the state-level counterpart to the federal HHS OIG LEIE (see the leie pack) for North Carolina specifically, and the sibling of ny_omig_check_exclusion (New York), ca_medical_check_exclusion (California), tx_medical_check_exclusion (Texas), fl_medical_check_exclusion (Florida), pa_medical_check_exclusion (Pennsylvania), ga_medical_check_exclusion (Georgia), oh_medical_check_exclusion (Ohio) and nj_medical_check_exclusion (New Jersey). Answers "is this provider excluded from North Carolina Medicaid" or pre-payment/credentialing screening for an NC Medicaid provider. An NPI or atypical-ID match is an IDENTIFICATION (both are exact, provider-specific identifiers); a name match against the EXCLUDED ENTITY field — even an exact one — is a CANDIDATE lead only, since this list carries no date of birth to tell same-named providers apart. A name that matches only the OWNERSHIP field (not the excluded entity) comes back as ownership_only_match with excluded:false — NC Medicaid's own note says an owner/principal name is NOT itself excluded unless separately listed. This dataset is a CURRENT SNAPSHOT (no history of lifted exclusions), so every match is currently_excluded:true. Pass npi or atypical_id to turn a name lead into an identification. Sourced from the NC Medicaid State Excluded Providers List, keyless.

What the NC Medicaid State Excluded Providers List covers and how current it is: total rows, how many carry an NPI vs. an atypical (non-NPI) ID, the distinct exclusion reasons published (FEDERAL, STATE, OIG, and combinations), and the oldest/newest exclusion effective dates. Notes that this is a CURRENT SNAPSHOT (not an ever-excluded history) — a reinstated provider simply disappears from the next monthly file. Pass year (e.g. 2025) or start_date/end_date to instead COUNT how many exclusions have an effective date in that year or range, counted over the whole list, not a page — answers "how many NC Medicaid exclusions took effect in 2025". The response names the date field counted (effective_date — NC Medicaid's own EFFECTIVE DATE column). Sourced from the NC Medicaid State Excluded Providers List, keyless.