{
  "name": "exclusion-screening-mcp",
  "title": "HealthMesh · Exclusion Screening (OIG LEIE + Medicare opt-out) MCP",
  "version": "0.1.1",
  "description": "Provider exclusion screening: the HHS-OIG List of Excluded Individuals/Entities (LEIE, bundled monthly snapshot, plus OIG monthly reinstatement supplements since January 2025) searchable by name, business name, NPI, state, specialty, exclusion authority and date; live Medicare opt-out affidavit checks and search (CMS data.cms.gov, latest monthly file); and a batch screen_provider tool combining LEIE and opt-out with match confidence. SAM.gov exclusions are not available (needs a SAM.gov API key).",
  "healthmesh_domain": "Fraud, Waste & Abuse",
  "datasets": [
    "FWA-01",
    "FWA-02",
    "FWA-03"
  ],
  "mcp_endpoint": "https://exclusion-screening.healthmesh.ai/mcp",
  "transport": "Streamable HTTP (stateless, JSON responses)",
  "authorization": "none",
  "auth_mode": "off",
  "docs": "https://github.com/HendrikK/healthmesh/tree/main/servers/exclusion-screening-mcp#readme",
  "contact": "hendrik.kleine@gmail.com",
  "data_source": {
    "name": "HHS-OIG LEIE (bundled monthly snapshot + reinstatement supplements) and CMS Medicare Opt Out Affidavits (live data.cms.gov)",
    "url": "https://oig.hhs.gov/exclusions/exclusions_list.asp",
    "license": "U.S. Government work (public)",
    "refresh": "LEIE bundled; monthly GitHub Actions check (exclusion-screening-check) flags a newer OIG UPDATED.csv; opt-out live"
  },
  "tools": [
    {
      "name": "leie_search",
      "title": "Search the OIG exclusion list (LEIE)",
      "description": "Searches the HHS-OIG List of Excluded Individuals/Entities (bundled monthly snapshot of UPDATED.csv) by individual last/first name, business name, NPI, state, specialty, exclusion authority (e.g. 1128a1, 1128b4) and exclusion date range. NPI is blank for ~89% of LEIE records, so name + DOB/state is usually needed to confirm identity. include_reinstated adds people/entities reinstated per OIG's monthly reinstatement supplements (January 2025 onward only). Results are possible matches, not verified identities."
    },
    {
      "name": "sam_search_exclusions",
      "title": "Search SAM.gov exclusions (not available)",
      "description": "NOT AVAILABLE in this deployment: the SAM.gov Exclusions API requires a SAM.gov API key, which HealthMesh does not hold. Validates the query and returns status not_available with links to the SAM.gov public exclusion search and API docs. Use leie_search for HHS-OIG exclusions."
    },
    {
      "name": "optout_check",
      "title": "Check NPIs for Medicare opt-out",
      "description": "Checks 1-100 NPIs against CMS's latest Medicare Opt Out Affidavits file (live data.cms.gov). Returns specialty, opt-out effective and end dates, computed status (active / ended / future) and eligibility to order and refer, plus the NPIs not found."
    },
    {
      "name": "optout_search",
      "title": "Search Medicare opt-out affidavits",
      "description": "Searches CMS's latest Medicare Opt Out Affidavits file (live data.cms.gov) by last/first name, specialty (word match, e.g. 'psychiatry', 'psycholog'), state, city or ZIP (5-digit prefix). Returns practitioners who opted out of Medicare with dates and computed active status."
    },
    {
      "name": "screen_provider",
      "title": "Screen providers (LEIE + Medicare opt-out)",
      "description": "Screens 1-500 providers (each with NPI and/or individual name or business name, optional state and DOB) against the OIG LEIE (bundled) and the Medicare opt-out list (live) in one call. Returns LEIE possible matches with confidence (high = NPI match, or full name + DOB; medium = full name + state, or business name; low = name only), the opt-out record, a risk_flag per provider, and a summary. SAM.gov is not checked (no API key). Screening aid only; not a substitute for official screening documentation."
    },
    {
      "name": "exclusion_describe_dataset",
      "title": "Describe the exclusion screening sources",
      "description": "Describes the bundled OIG LEIE snapshot (rows, last-modified date, reinstatement months, exclusion authority codes with counts and labels), checks whether OIG has posted a newer file, and names the live Medicare opt-out file."
    }
  ]
}