Texas Inspector General Exclusion List

The Texas Office of the Inspector General works to protect the health and welfare of people receiving Medicaid and other state benefits. To help protect these recipients, OIG may prevent certain people or businesses from participating as service providers. The people or businesses who are excluded from participating as providers are added to the Texas Exclusions List. Reasons for exclusion may include:

• A conviction for program-related fraud, or patient abuse
• An adverse action by a licensing board, such as the Texas Board of Nursing, or Texas Medical Board
• Being excluded by from the Medicare 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).