Fl Medical Exclusions

What Fl Medical Exclusions MCP server does

Fl Medical Exclusions MCP server checks Florida providers against sanction final orders published by the Florida Agency for Health Care Administration (AHCA). Queries can use a provider name, an exact NPI, a Florida license number, or a Medicaid provider number. The dataset contains one record per final order rather than one record per provider, so a provider can produce multiple matches.

The integration separates sanctions from participation exclusions. Suspension orders represent a one-year preclusion, and termination orders represent a twenty-year preclusion. Fines and corrective action plans remain sanctions but do not by themselves exclude a provider from Florida Medicaid. Each result identifies its sanction class and whether it is a participation exclusion.

Name matches are candidate leads only because AHCA does not publish dates of birth. NPI, license, and Medicaid provider-number matches provide the identification signal used by the tool. Results can also include violation codes and their AHCA descriptions, fine amounts, AHCA case numbers, formal or informal case numbers, and a derived nominal preclusion end date.

How it works

The source is AHCA's Medicaid Sanctioned Providers search in its Public Records system, together with AHCA's published information sheet for sanction definitions and violation-code descriptions. The source application requires a stateful WebForms session and an SSRS report export. A bake script reproduces that session, downloads the Excel export, parses it, and stores the resulting index for deployment.

Requests use the deployed baked index instead of waiting for the upstream site. The response reports a data_as_of value so consumers can assess the age of the copy. The index contained 7,014 unique orders at the documented capture point, after duplicate rows were collapsed. It must be regenerated periodically when fresher data is required.

Matching is exact for ten-digit NPIs. License matching ignores case and punctuation, and only removes leading zeroes when both values are numeric. Medicaid provider numbers are normalized to nine digits. Name searches ignore case and punctuation and allow words in any order. Within each matching tier, exclusion orders appear before fines and newer records appear first; limit controls the returned count.

Tools and capabilities

fl_medical_check_exclusion accepts optional name, npi, license, medicaid_provider_number, and limit arguments. Its top-level identified_participation_exclusion field gives screeners a direct answer for an identity-grade exclusion match. Individual matches include sanction and case details, violation information, and exclusion-related fields.

fl_medical_exclusion_coverage reports the dataset's order totals, sanction-class distribution, participation-exclusion counts, distinct-provider counts, identifier coverage, violation-code counts, date range, and capture time. The coverage response helps developers understand how complete and current the baked copy is before relying on it.

Limitations and notes

Fl Medical Exclusions MCP server does not establish that a provider is currently excluded from Medicaid. AHCA publishes no reinstatement date or date of birth. The nominal end date is calculated from the sanction date and AHCA's stated one-year or twenty-year term, and is explicitly derived. A separate rescinded order is the published signal that an exclusion was lifted early.

The source list is not a complete historical record of every sanction: AHCA notes that some sanctions before July 1, 2009 did not always produce final orders. Violation codes outside AHCA's supplied key are retained without an invented description. The upstream source has no identified Socrata mirror, so freshness depends on rerunning the bake process and redeploying the index.

Authentication is not required. This is an independent, unofficial integration and is not affiliated with, endorsed by, or published by AHCA.