Tennessee Exclusion List

Providers in this list have been terminated for cause from participation in the TennCare Medicaid program. No TennCare funds will be used to pay for healthcare services provided, ordered or prescribed by these individuals. Additionally, any healthcare entity in which these persons owns a 5% or greater interest risks being terminated from the participation in the TennCare program.

• Why it matters: Services ordered, referred, or rendered by excluded parties are non‑payable; employing or contracting with excluded providers risks recoupment and civil monetary penalties.
• What to verify: Legal name and aliases, NPI/Medicaid ID, license/board status, date of birth (if available), last known city/state, and exclusion effective/end dates.
• Update cadence: Typically updated monthly by the state. Record the file’s “as of” date and screen at hire and monthly thereafter.
• Compliance tips:
  • Cross‑check with OIG LEIE and SAM.gov and retain dated evidence of each search.
  • Add system blocks to prevent ordering/prescribing by excluded providers.
  • Document remediation steps for positive matches (schedule removal, claim holds, notifications).