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Tx Medical Check Exclusion

tx_medical_check_exclusion
Read-onlyIdempotent

Is this healthcare provider excluded from the Texas Medicaid program? Screens a person or business name, an NPI, and/or a license number against the Texas HHSC Office of Inspector General (OIG) Medicaid Provider Exclusions Database — the state-level counterpart to the federal HHS OIG LEIE (see the leie pack) for Texas specifically, and the sibling of ny_omig_check_exclusion (New York) and ca_medical_check_exclusion (California). Answers "is this provider excluded from Texas Medicaid", "check this NPI against the Texas exclusions list", or pre-payment/credentialing screening for a Texas 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. Every match carries HHSC OIG's own free-text reason (e.g. "Federal mandated exclusion", "Conviction relating to Healthcare Fraud") and a currently_excluded flag DERIVED from whether the provider has since been reinstated — this dataset covers everyone EVER excluded, not only those currently excluded. Pass npi or license to turn a name lead into an identification. Sourced from the Texas HHSC OIG Exclusions Database File, 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 individual name and company name, any word order.
limitNoMaximum matches to return (default 10, max 50).
licenseNoTexas professional license 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?

Annotations already cover the safety profile (readOnly, idempotent, non-destructive), yet the description adds substantial behavioral context: name matches are candidate leads only because the list lacks DOB, while NPI/license matches are identifications; the dataset covers everyone ever excluded and currently_excluded is derived from reinstatement. This is meaningful disclosure beyond what structured fields provide.

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 central question and mostly dense and information-rich. It is long and repeats the identification-vs-candidate-lead distinction twice (once in prose, once in the closing sentence), which is slight redundancy but not padding.

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: match reason text, currently_excluded flag, and the ever-excluded scope are all explained. An agent has everything needed to call it and interpret results.

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 baseline is 3, but the description adds epistemic weight per identifier type — NPI/license turn a name lead into an identification — and notes name matching works across word order. This is useful semantics layered on top of the schema rather than mere repetition.

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 (screens) and resource (Texas HHSC OIG Medicaid Provider Exclusions Database) and frames the core question it answers. It explicitly positions itself against named siblings (leie pack, ny_omig_check_exclusion, ca_medical_check_exclusion), so an agent can distinguish it without opening the 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 when-to-use scenarios (pre-payment/credentialing screening, 'is this provider excluded from Texas Medicaid', checking an NPI) and names the alternative jurisdictions/tools. Nothing about when to reach for this versus the New York or California counterparts is left 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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