Colorado Exclusion List
Overview and guidance for this database. Use SecureEPLS to screen quickly and confidently.
The Department of Health Care Policy and Financing (HCPF) maintains a list of providers whose participation in
the Colorado Medicaid program has been terminated for cause. A provider who has been terminated for cause may
not receive reimbursement under the Medicaid program. A description of the reasons a provider may be terminated
for cause can be found under the definition of Good Cause at 10 CCR 2505-10, Section 8.076.1.7.
- 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).
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