Tx Medical Exclusions

What Tx Medical Exclusions MCP server does

Tx Medical Exclusions MCP server exposes Texas Health and Human Services Commission Office of Inspector General (HHSC OIG) Medicaid provider exclusion data through MCP tools. The underlying download contains providers ever excluded from Texas Medicaid, including records for people or entities later reinstated. At capture time, the dataset contained about 13,443 rows.

The main screening tool accepts an optional provider name, NPI, license number, and result limit. NPI and license matches provide stronger identification because they use provider-specific fields. Name matching is case- and punctuation-insensitive, and searches assembled individual names or company names. Because the source does not include dates of birth and many individual records lack company names, a name match is only a candidate lead.

Each match includes HHSC OIG's free-text reason, dates and identifiers where available, and a currently_excluded value. That status is derived from whether ReinstatedDate is blank; it is not a boolean directly published by HHSC. The reason text is not normalized and may contain inconsistent wording.

How it works

The source is HHSC OIG's Download Exclusions File page. The project retrieves the file by replaying the site's ASP.NET WebForms form flow: it first obtains hidden state fields and session cookies, then submits the download postback. The resulting text export is processed into a baked index rather than queried through a live request for each tool call.

Tx Medical Exclusions MCP server uses exact 10-digit numeric matching for NPI values. License comparisons use digits only and remove leading zeroes. The source contains some malformed NPI values, which are retained in output but are not used for NPI matching. Coverage statistics include total historical exclusions, current and reinstated counts, identifier availability, occupation diversity, and the oldest and newest exclusion dates.

The download includes both currently excluded and reinstated providers, unlike HHSC's online search page, which reports currently excluded providers only. Responses identify the capture date so callers can judge how old the baked data may be.

Setup and configuration

Connect an MCP client to the remote endpoint:

{
  "mcpServers": {
    "tx-medical-exclusions": {
      "url": "https://gateway.pipeworx.io/tx-medical-exclusions/mcp"
    }
  }
}

The service is keyless. No account is needed for the first calls. Applications that do not use MCP can call the HTTP tool endpoint directly, for example:

curl -X POST https://gateway.pipeworx.io/v1/tools/tx_medical_check_exclusion \
  -H 'Content-Type: application/json' \
  -d '{"name":"Gordzelik"}'

The scoped MCP endpoint also lists shared Pipeworx gateway tools in addition to the pack-specific tools. A full-gateway URL is available when an application wants all source packs listed directly.

Tools and capabilities

• tx_medical_check_exclusion: Search by name, NPI, or license number, optionally limiting returned matches.
• tx_medical_exclusion_coverage: Inspect totals, current and reinstated counts, identifier coverage, occupations, and exclusion date range.
• Return source-derived reason text and explicit caveats about free-text reasons and derived current status.
• Preserve historical exclusions so screening workflows can distinguish ever-excluded records from records that remain excluded.

Limitations and notes

The data is not a live proxy. The baked copy must be periodically regenerated and redeployed, and data_as_of indicates its capture date. A missing or malformed baked-index injection is treated as an error rather than as a negative search result.

An exact name match does not establish identity. Confirm candidates with an NPI or license number and review the source details. NPI matching is restricted to well-formed 10-digit values, while license matching follows the normalized digits-only comparison described above. The integration is independent and unofficial; it is not affiliated with, endorsed by, or published by HHSC OIG.