West Virginia Medicaid Provider Sanctioned/Exclusion
Overview and guidance for this database. Use SecureEPLS to screen quickly and confidently.
The West Virginia Sanctioned/Excluded Providers are businesses and individuals that are excluded from doing
business with government and other entities in the state of West Virginia.
- 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).
<< Back to Exclusion Database List
