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Oh Medical Check Exclusion

oh_medical_check_exclusion
Read-onlyIdempotent

Is this healthcare provider excluded from, or suspended from, the Ohio Medicaid program? Screens a person or organization name, an NPI, and/or an ODM Provider ID against the Ohio Department of Medicaid (ODM) Provider Exclusion & Suspension List — the state-level counterpart to the federal HHS OIG LEIE (see the leie pack) for Ohio specifically, and the sibling of ny_omig_check_exclusion (New York), ca_medical_check_exclusion (California), tx_medical_check_exclusion (Texas), fl_medical_check_exclusion (Florida), pa_medical_check_exclusion (Pennsylvania) and ga_medical_check_exclusion (Georgia). Answers "is this provider excluded from Ohio Medicaid", "check this NPI against the Ohio ODM exclusion list", or pre-payment/credentialing screening for an Ohio Medicaid provider. An NPI or Provider ID match is an IDENTIFICATION (both are exact identifiers ODM assigns/records, and either can be a comma-joined list on one row when a provider is excluded under multiple registrations); a name match — even an exact one — is a CANDIDATE lead only, since this list carries no date of birth. Every match carries ODM's own Status field (Excluded, Suspended, or occasionally Terminated/blank) and a currently_excluded flag DERIVED from it — null with status_unknown:true when the status is not a recognized Excluded/Suspended value, rather than a guess. Pass npi or provider_id to turn a name lead into an identification. Sourced from the Ohio ODM Provider Exclusion & Suspension List, 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 organization name to screen, e.g. "John Smith" or "Acme Home Health". Matched against the provider's individual name and organization name, any word order.
limitNoMaximum matches to return (default 10, max 50).
provider_idNoODM's own Provider ID, if known. A Provider ID match is an identification.

Schema Changelog

Changes observed during successful MCP inspections.

  1. First observed

TDQS

A4.6/5.0
Behavior4/5

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

Goes well beyond the readOnly/idempotent annotations: it explains that name matches are only candidate leads (no DOB on the list), that NPI/Provider ID matches are identifications, that a matched row carries ODM's Status field with a derived currently_excluded flag, and that unknown statuses return null with status_unknown:true rather than a guess. Only missing detail is result volume/truncation behaviour beyond the limit param.

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 screening question, then scope, then match semantics, then the ID-escalation advice — a sensible order. It is a single dense paragraph and the full enumeration of seven state siblings is more verbose than needed; a shorter pointer would carry the same routing value.

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 takes on return-value explanation and does so: per-match Status values, the derived currently_excluded flag and its status_unknown fallback, and the identification-versus-lead distinction. Source and auth model (keyless) are also stated, leaving nothing material an agent needs to call this correctly.

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; the description still adds interpretive meaning the schema does not — what a match on each parameter *means* evidentially (identification vs candidate lead) and that either ID can be a comma-joined multi-registration list. It does not restate the limit param, which is fine since the schema covers it.

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?

Opens with a direct question form of a specific verb+resource: screening a provider against the Ohio Department of Medicaid Provider Exclusion & Suspension List. Explicitly positions itself against the federal LEIE counterpart and names the state siblings (ny_omig, ca_medical, tx_medical, etc.), so an agent can pick the right state without opening a schema.

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 use cases (pre-payment/credentialing screening for an Ohio Medicaid provider) and states the geographic boundary — Ohio specifically — while pointing to the LEEI pack for federal and to named siblings for other states. It also stipulates the escalation path: pass npi or provider_id to turn a name lead into an identification.

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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