Compliance guideRead at source, 28 September 2026

OIG Exclusion Check: How to Screen Employees Against the LEIE (2026)

An OIG exclusion check is a search of the HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) to confirm that a candidate, employee or contractor is not barred from federal health care programs. Federal programs pay nothing for items or services an excluded person furnishes, and an employer that hires someone it “knows or should know” is excluded faces civil money penalties of up to $20,000 per item or service (adjusted for inflation) plus an assessment of up to three times the amount claimed. OIG recommends checking before hire and every month, because the list is updated monthly.

What the OIG exclusion list is

HHS-OIG can exclude individuals and entities from federally funded health care programs under sections 1128 and 1156 of the Social Security Act (42 U.S.C. 1320a-7 and 1320c-5). The LEIE is OIG’s list of everyone currently excluded. People who have been reinstated are removed from it.

Some exclusions are required by law. OIG must exclude anyone convicted of Medicare or Medicaid fraud or another program-related crime, patient abuse or neglect, a felony related to health care fraud, or a felony related to controlled substances. Others are discretionary, such as a license revocation or suspension for reasons bearing on professional competence or financial integrity, or defaulting on health education loans.

Two things about that table surprise employers. Exclusion does not end on its own: an excluded person must apply to OIG and receive written notice of reinstatement. And the list names people by the name OIG knew at the time of exclusion, which is why you search every name a candidate has used.

What happens if you employ an excluded person

Under 42 CFR 1001.1901, no Medicare, Medicaid or other federal health care program payment will be made for any item or service furnished by an excluded individual. OIG’s 2013 bulletin spells out how far that goes. It applies whether payment comes from itemized claims, cost reports, fee schedules, capitated payments or a bundled prospective payment. Its own example: no payment may be made to a hospital for services an excluded nurse furnished, “even if the nurse’s services are not separately billed.” It also covers administrative and management work, such as HR, billing, staff training or office management at a provider paid by federal programs, “unless wholly unrelated” to those programs.

The employer’s own exposure comes from the Civil Monetary Penalties Law. 42 U.S.C. 1320a-7a(a)(6) covers anyone who “arranges or contracts (by employment or otherwise) with an individual or entity that the person knows or should know is excluded.” The consequences:

• A penalty of not more than $20,000 for each item or service, for conduct after February 9, 2018 (42 CFR 1003.210(a)(4)). The amounts are adjusted for inflation each year under 45 CFR part 102.
• An assessment of not more than three times the amount claimed for each separately billable item or service, or, where the excluded person’s work is not separately billable, three times the total costs of employing them, “including salary, benefits, taxes” (42 CFR 1003.210(b)(2)).
• Exclusion of the employer itself, which the statute allows in the same proceeding.
• Overpayment liability for anything federal programs paid for the excluded person’s work, whoever performed the screening.

That second bullet matters most for a nursing home or hospital, where an aide’s or nurse’s work is paid through a per diem or bundled rate rather than a separate claim. The measure there is what you spent employing the person.

Is an OIG exclusion check required?

Not by a statute or regulation that names the LEIE, which OIG’s 2013 bulletin says plainly: “Providers are not required by statute or regulation to check the LEIE.” But the penalty applies when you “knew or should have known,” and the list is free and public. OIG’s position is that to avoid potential liability, providers should check the LEIE before employing or contracting with anyone, and periodically after that. In practice, a health care employer that doesn’t screen will have a hard time arguing it could not have known.

State Medicaid agencies are required to check. 42 CFR 455.436 makes them check the LEIE and the federal debarment list for enrolled providers at enrollment and no less often than monthly. OIG’s bulletin notes CMS recommended in 2009 that states require providers to screen all employees and contractors monthly, and your state Medicaid provider agreement may make that a contract term.

Who to screen

OIG recommends reviewing each job category and contract: if the work is directly or indirectly, in whole or in part, payable by a federal health care program, screen everyone in it. For most health care employers that is nearly everyone. The bulletin’s own examples reach past clinicians:

• Clinical staff: nurses, aides, therapists and technicians, including those with no direct patient contact whose work is paid through a bundled rate.
• Administrative staff: billing, coding, claims processing and management roles.
• Volunteers and non-employed medical staff. Liability can arise “even if the excluded person does not receive payments from the provider.”
• Agency and contract staff. OIG recommends screening staffing agency nurses, contracted physician groups and billing companies, or getting and keeping the contractor’s screening documentation.

If you rely on a staffing agency, put the screening obligation in the contract and check that it is being done. The bulletin says a hospital may reduce or eliminate its liability if it can show it reasonably relied on the agency’s LEIE checks and exercised due diligence. See nurse staffing agency costs for the contract side.

How often to check the OIG exclusion list

Before hire, then monthly. OIG updates the LEIE every month with the prior month’s actions, and its bulletin says that “screening employees and contractors each month best minimizes potential overpayment and CMP liability.” An employee who was clear at hire can be excluded later, for conduct at a previous job or a license action in another state. A one-time check at onboarding misses that.

How to run an OIG exclusion check, step by step

• Collect every name. Current legal name, maiden and prior married names, and each part of a hyphenated name (OIG’s example: check Jane Smith-Jones as Jane Smith and Jane Jones too).
• Search the LEIE online search for a few people at a time; it takes up to five names per search. Enter only the first few letters of the first and last names, and include apostrophes and hyphens.
• Or use the downloadable file for your whole roster. OIG publishes a CSV of the entire LEIE, replaced each month, plus monthly supplement files of new exclusions and reinstatements. OIG recommends re-downloading the full file rather than relying only on supplements.
• Verify any name match with a Social Security number (individuals) or EIN (entities) in the online search, as described below.
• Document every search. Use the online search’s Print Search Results button (OIG says the browser’s print function will not work) and keep the record of the initial search and any follow-up searches.
• Repeat monthly for everyone on payroll, contractors and volunteers.

If a vendor runs the checks for you, remember the bulletin’s warning: the provider keeps the liability if an excluded person is employed. Exclusion screening fits alongside the rest of your pre-hire checks; the order they run in is on how to vet a candidate, and the healthcare-specific set is on healthcare background checks.

How to verify an LEIE match

“It is not sufficient to simply find a matching first and last name on the LEIE,” OIG says. A common name will produce false matches. To confirm or rule one out:

• Open the record. Click Verify (or the person’s last name) in the online search to see the data OIG holds: provider type, exclusion authority, state, and where available date of birth, address and NPI.
• Enter the SSN or EIN in the box under the record. The online search uses what you enter as a matching criterion; it never displays SSNs. After three wrong entries you get a captcha, and a fourth miss sends you back to the start.
• Downloadable file users must still verify in the online search, because the Privacy Act keeps SSNs and EINs out of the CSV.
• If a field is blank, OIG doesn’t hold it. Contact the Exclusions Branch at exclusions@oig.hhs.gov.

SAM exclusion check and state Medicaid lists

The General Services Administration’s System for Award Management (SAM.gov) holds debarment actions by many federal agencies, including OIG’s exclusions. The LEIE holds only OIG’s. OIG recommends the LEIE as your primary exclusion source because it is updated monthly and carries more detail, such as the legal basis, occupation, date of birth and address. OIG also notes it has no authority to impose CMPs for employing a debarred person, so a SAM check covers a different risk; many employers run both.

Your state Medicaid program is a third source. Federal rules require state Medicaid agencies to deny or end the enrollment of providers terminated by Medicare or by another state’s Medicaid program (42 CFR 455.416). Ask your state Medicaid agency’s program integrity office whether it publishes its own exclusion or termination list, and whether your provider agreement requires you to screen against it.

What to do on a hit

• Confirm it with the SSN verification before acting; a name match alone is not a finding.
• For a candidate, don’t put them in a role whose work is paid, directly or indirectly, by a federal health care program. OIG’s bulletin allows employment only where the work is not federally reimbursed or serves only non-federal program patients.
• For a current employee or contractor, remove them from any federally reimbursable work, then read the 2013 bulletin and OIG’s Provider Self-Disclosure Protocol. OIG’s FAQ points employers who have already hired an excluded person to that protocol.
• Check for a waiver. OIG can waive an exclusion within a defined scope, and publishes the waivers in effect.
• Keep the records: the search, the verification and what you did.

Screening protects the hire. Recruiting sets the pool.

An exclusion check removes a small number of people from a healthcare applicant pool. For roles like CNAs, pair it with registry verification; see CNA verification.

Related: hiring compliance by stage, what is a background check and CNA job description.

Frequently asked questions

Sources: HHS-OIG Exclusions Program pages, LEIE Quick Tips & Instructions, LEIE Database & Supplement Downloads, Background Information & Exclusion Authorities and Exclusions FAQ (last updated April 30, 2026); HHS-OIG Updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs (May 8, 2013); 42 U.S.C. 1320a-7a (uscode.house.gov); 42 CFR 1001.1901, 1003.200, 1003.210, 455.416 and 455.436 and 45 CFR 102.3 (eCFR, current to 25 September 2026); HHS-OIG Self-Disclosure Information; Boostpoint 2026 Social Job Advertising Benchmark. General information, not legal advice. Read at source 28 September 2026.