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Exclusion screening by provider type: what OIG's guidance says

Reviewed against the source · HHS Office of Inspector General, SAM.gov

HHS-OIG's bulletin frames screening scope by job category and contractual relationship rather than by provider type: a provider should review each one and screen where the item or service is directly or indirectly, in whole or in part, payable by a Federal health care program. The underlying rule — Federal health care programs do not pay for items or services furnished by an excluded person — is the same for every setting.

Which roles and vendors does OIG's bulletin say to screen?

The bulletin's own examples: a hospital screening nurses supplied by a staffing agency, physician groups that contract with a hospital to provide emergency room coverage, and billing or coding contractors. It also discusses pharmacy work, noting that services performed by excluded pharmacists, or by excluded people who input prescription information for pharmacy billing or are involved in filling prescriptions billed to a Federal health care program, are covered by the prohibition. For contractors, OIG says providers may rely on screening conducted by the contractor or screen for themselves; the provider remains subject to overpayment liability either way.

Can an organization itself appear on the LEIE?

Yes. The LEIE lists individuals and entities, so a pharmacy or other business can appear on it as an entity, not only the individuals within it. The bulletin also notes that an excluded person may own a provider but may not provide items or services, including administrative and management services, payable by Federal health care programs.

Requirements can differ if you are enrolled in a state Medicaid program. This site does not summarise state-by-state requirements; check the terms of any state program you participate in.

Sources

Where this page says “our characterisation,” “our reasoning,” or “we measured,” the statement is CFExclusion's own rather than a government source's. CFExclusion is a private service and is not affiliated with HHS, OIG, CMS, or SAM.gov.

Check a name

Looking for a specific name? Search the HHS-OIG LEIE, SAM.gov exclusions, and Medicaid exclusion lists from 41 states — free, with no signup for your first 3 searches a day.

Adding a state or NPI lets us confirm a match with more confidence.

A $25 report turns that search into a dated, signed record: proof this name was checked against all 43 sources — HHS-OIG LEIE, SAM.gov, and 41 state Medicaid lists — on a specific date, clear or not. See a sample report →

A single check is a snapshot: HHS-OIG replaces the LEIE around the middle of every month, so a result from last month no longer reflects who's on the list today. OIG's own guidance recommends screening your full workforce and vendors on that same monthly cycle — a best practice it states plainly, not a legal mandate. What OIG's guidance actually says about monthly screening → · See the monthly screening service →

For new federal enforcement actions and court records every day, see CourtPulse (courtpls.com).

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