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Ca Medical Check Exclusion

ca_medical_check_exclusion
Read-onlyIdempotent

Is this healthcare provider barred from California's Medi-Cal program? Screens a person or business name, an NPI, and/or a license/provider number against the California DHCS Medi-Cal Suspended and Ineligible (S&I) Provider List — the state-level counterpart to the federal HHS OIG LEIE (see the leie pack) for California specifically, and the sibling of ny_omig_check_exclusion for New York. Answers "is this provider excluded from Medi-Cal", "check this NPI against the California S&I list", or pre-payment/credentialing screening for a California Medicaid provider. An NPI or license-number match is an IDENTIFICATION (both are exact, provider-specific identifiers); a name match — even an exact one — is a CANDIDATE lead only, since this list carries no date of birth to tell same-named providers apart and many entity rows have no first/middle name. Returns provider type, any AKA/DBA, and the suspension effective date for every match. DHCS's published data does not include a per-record exclusion reason or statute (every response names the list-wide statutory basis instead: Welfare & Institutions Code §§14043.6/14123). Pass npi or license to turn a name lead into an identification. Sourced from the California DHCS S&I List via the CHHS Open Data Portal, keyless.

Input Schema

NameRequiredDescriptionDefault
npiNoThe provider's 10-digit NPI, if known. An NPI match is an identification rather than a name lead — always pass it when known.
nameNoProvider or business name to screen, e.g. "John Smith" or "Acme Pharmacy Corp". Matched against the provider's name and any listed AKA/DBA, any word order.
limitNoMaximum matches to return (default 10, max 50).
licenseNoCalifornia professional license/registration number, if known. A license match is an identification.

Schema Changelog

Changes observed during successful MCP inspections.

  1. First observed

TDQS

A4.8/5.0
Behavior5/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

Goes well beyond the readOnly/openWorld/idempotent annotations by disclosing that an NPI or license match is an identification while a name match is only a candidate lead (no DOB, entity rows lack first/middle name), what the response contains (provider type, AKA/DBA, suspension effective date), and that the source lacks a per-record exclusion reason. That is exactly the kind of behavioral context annotations don't carry, and it does not contradict any hint.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness4/5

Is the description appropriately sized, front-loaded, and free of redundancy?

Front-loaded with the core question, then dense supporting detail. It is on the long side and the identification-vs-lead point is restated more than once, but nearly every sentence (false-positive risk, statutory basis, sourcing) earns its place.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness5/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

With no output schema, the description carries the return-value burden and does so: it names provider type, AKA/DBA, and suspension effective date, plus the list-wide statutory basis. Combined with the sourcing note (keyless CHHS Open Data Portal), an agent has everything needed to call and interpret the tool.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters4/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema coverage is 100%, so the baseline is 3, but the description adds interpretive value beyond the schema by explaining that passing npi or license converts a name lead into an identification, and that names match against name plus AKA/DBA in any word order. The limit parameter is left to the schema, which documents it fully.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

States a specific verb and resource: screens a provider against the California DHCS Medi-Cal Suspended and Ineligible (S&I) Provider List. It explicitly distinguishes itself from the federal HHS OIG LEIE and names ny_omig_check_exclusion as the New York counterpart, so an agent can tell it apart from adjacent tools.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines5/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

Gives concrete trigger contexts (pre-payment/credentialing screening for a California Medicaid provider) and example questions ("is this provider excluded from Medi-Cal", "check this NPI against the California S&I list"). It also routes to alternatives by naming the federal LEIE pack and the New York sibling, leaving little to inference.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

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