ClearRoster · Guide · Washington
How to check the Washington Medicaid exclusion list every month
If your practice bills Apple Health (Washington's Medicaid program), check your staff, contractors and vendors against Washington's own exclusion list as well as the federal ones. A person can be on a state list without being on the federal OIG list, and vice versa. This page shows where Washington's list is, how to check it yourself for free, and how to keep a record that you did.
Where the Washington list is
The Apple Health provider termination and exclusion list is published by the Washington State Health Care Authority (HCA) at www.hca.wa.gov. HCA posts two spreadsheets (XLSX) on that page: one for Medicaid providers and one for DSHS social services providers. Each entry has the name, license number, NPI or provider ID, date of exclusion and the action taken.
The monthly routine
- Keep a roster of everyone who works on anything billed to Medicaid or Medicare: employees, contractors and the vendors you pay. Note each person's full legal name, any other last names, and their NPI or license number if you have them.
- Each month, get the newest copy of the Washington list from the page above and note its date.
- Look up every name. Try the last name on its own as well as last plus first, because spelling and name order vary. Look up businesses by their legal name and any "doing business as" name.
- Treat a name match as a question. Compare the NPI, license number, address or other details on the list with what you hold before deciding it is the same person. If you are unsure, contact the Washington State Health Care Authority (HCA).
- Check the federal lists too: the OIG exclusion list and SAM.gov. The main guide covers those step by step.
- Keep a dated record: the date you checked, the date of each list, the names checked, any close matches and how you resolved them. Save the file or search results you used.
If a match is confirmed, stop the person's involvement in anything billed to Medicaid or Medicare and talk to your attorney or compliance adviser.
Limits to know
- A list is only as current as its last update, so use the newest copy each time.
- Someone can be listed under another name you don't have.
- Washington may have other screening requirements for your type of practice, such as license checks.
If you want it done for you: ClearRoster
ClearRoster does not check the Washington list right now (could not be read: https://www.hca.wa.gov/assets/billers-and-providers/termination-exclusion.xlsx: HTTP 403 (refused; not retried)), so you would still need to check it yourself. What it does check is listed below.
Everything it checks today: the OIG list and SAM.gov, plus the Medicaid lists of 20 states: Pennsylvania, New York, New Jersey, California, Georgia, Missouri, Indiana, North Dakota, Iowa, Arkansas, North Carolina, South Carolina, Maryland, Kentucky, Montana, Delaware, Alaska, Wyoming, Nevada, District of Columbia. Each record names every list it did not check.
Price: a 14-day free trial with no card needed to start, then $29 a month for up to 100 people and vendors or $49 for up to 500.