Each one is currently on the OIG LEIE or SAM.gov exclusion list and still appears in the CMS National Directory of Healthcare. We have produced a per-provider file your Program-Integrity and MMIS teams can act on this week — with primary-source verification links on every row so nothing has to be taken on faith.
Three steps. Your PI team probably runs all three in the same week.
ainpi.dev/api/v1/states/id-cohort-critical.csv
Opens in Excel. 31 rows. Twelve columns including LEIE exclusion date, SAM active date, NPPES deactivation date, and one-click verification URLs to the federal portals.
Their existing workflow takes over from here: verify each row against the federal portals (links on the row), check whether your MMIS already has the provider flagged, queue any unflagged matches for revalidation or payment-suspension review. The per-provider verification URLs mean no one has to take AINPI's word for it — every flag is independently checkable against the primary source.
The CMS State Medicaid Director letter (2026-04-23, response due 2026-05-23) requires states to demonstrate five elements of a comprehensive provider-revalidation strategy. AINPI gives you the “public-facing data or reporting” Element 2 asks for. Citation language ready to paste is at ainpi.dev/smd-revalidation.
Click any portal link. Confirm the same NPI shows as currently excluded on the federal source. This is the verification chain your PI team will run, but you can run it yourself in your browser right now.
The CMS State Medicaid Director letter dated 2026-04-23 requires each state Medicaid agency to submit a comprehensive provider-revalidation strategy by 2026-05-23. The letter is structured around five elements; the first four require checking enrolled providers against four federal databases:
AINPI has already completed the first three federal database checks for all states. For Idaho, the output is the file above. Element 2 of the SMD letter asks for “public-facing data or reporting” — AINPI is that data, free, citable, and continuously refreshed against new federal releases.
We have no contract requirement, no procurement process, and no AINPI-internal account creation. Your team downloads the file and runs their existing verification workflow.
AINPI also cross-references Idaho's 31 federally-excluded providers against five public federal claims and payment datasets: Medicaid spending (2018–2024), Medicare Part B billing (CY 2023), Medicare Part D prescribing with opioid metrics (CY 2023), Open Payments industry transfers (PY 2024), and NPPES deactivation status. Each finding below is citation-ready for the “other comprehensive measures” element of your CMS State Medicaid Director response.
0 of 5 matched Idaho providers received Medicaid payment strictly after their LEIE or SAM exclusion took effect ($0 strict-post- exclusion, $821K full-window 2018–2024 across all state Medicaid programs that paid the NPI). The HHS spending file has no state-of-payment column, so the full-window dollar figure aggregates payment from every state that paid the NPI; state attribution is by NPPES practice state. Detail file: h29-excluded-paid.csv.
1 Part B billers ($5K full-window; 0 strictly post-exclusion at $0) and 1 Part D prescribers ($39K drug cost; 1 opioid prescribers). Pre-exclusion billing reflects work the provider was authorized to do at the time; the strict-post-exclusion subset is the direct § 455.436 violation signal. Opioid-prescriber subset feeds directly into the DEA Opioid Coordination queue under the 21st Century Cures Act and 2018 SUPPORT Act. Detail files: h30a Part B · h30b Part D.
0 NPPES-deactivated Idaho-state NPIs billed at least one public claims source strictly after their NPPES deactivation date. Post-deactivation totals: Medicaid $0, Medicare Part B $0, Medicare Part D $0 drug cost. Each match is either a data-quality problem (NPI reused or misattributed) or evidence of work being done under a closed identifier — both are state PI triage flags. Detail file: h31-deactivated-paid.csv.
0 federally- excluded Idaho-resident providers received pharmaceutical or device-manufacturer payments in Program Year 2024 ($0 full-window; 0 strictly post-exclusion at $0). The Sunshine Act surface is regulator territory for HHS-OIG, FDA, and DEA — but a state PI office citing this in a comprehensive-strategy submission is naming a real federal gap. Detail file: h32-excluded-industry-payments.csv.
99.99984% of material Medicare Part B billers nationally are present in the federal directory (only 2 of 1.26M individual NPIs absent). What fails is currency — keeping deactivated and excluded providers off the list. For Idaho specifically: the organization-NPI duplicate rate is 39.7% (7,377 of 18,562 organization rows in Idaho). NPI taxonomy correctness is 99.41% against the CMS Medicare crosswalk.
The strongest signals in Idaho's cohort are the NPIs that appear in multiple files at once (exclusion list + Medicaid spending + Medicare Part B/D billing). AINPI produces the files; your PI team reads the multi-source matches first, single-source matches second. Pre-exclusion billing reflects work the provider was authorized to do at the time — the regulatorily significant subset is the strict-post-exclusion column in each file.
AINPI runs this audit for every US state and DC. Each state's file is at ainpi.dev/for-state-medicaid/<state> — for example, Virginia, South Carolina, Pennsylvania, Ohio, North Carolina. The shape is identical state to state; only the file content differs.
Virginia has been the pilot state for this work; the Department of Medical Assistance Services (DMAS) shaped much of the format you see here. Read the Virginia briefing for the full deeper-dive version of what AINPI gives a state.
Pass these to the PI / MMIS / data team after a forward. None of this is required reading for the CMO version above.
AINPI is produced by FHIR IQ. Built for state Medicaid agencies, shaped by direct work with the Virginia Department of Medical Assistance Services. Free, public, citable.
Questions: reply to gene@fhiriq.com. We do not charge state Medicaid agencies for access, support, or per-state cohort builds.