Kentucky Medicaid Program Terminated and Excluded Provider List

The Kentucky Department for Medicaid Services maintains a list of providers whose Medicaid provider agreement either have been terminated or who have been placed on an exclusion list. An individual or entity terminated or excluded from participating in the Kentucky Medicaid program will not be reimbursed for services provided in any capacity or in any category under the Kentucky Medicaid 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).