Why exclusion checks matter
The HHS Office of Inspector General keeps a list of people and businesses excluded from Medicare, Medicaid and other federal health programs. Federal programs do not pay for anything an excluded person orders, prescribes or provides, and an employer that bills for their work can face civil money penalties. That is why practices, pharmacies, home health agencies and staffing firms screen staff and providers, usually every month.
How we match
- Excluded (NPI match): the OIG entry lists this exact NPI.
- Possible match: most OIG entries have no NPI. When the provider's last name, first name and state match an excluded person, we flag it. Confirm a possible match on the OIG search before acting on it. OIG lets you verify with a Social Security number.
This check covers the OIG list only. A full compliance program also checks SAM.gov and the state Medicaid exclusion lists.
Screening a whole list
The bulk lookup checks every NPI in a spreadsheet against the OIG list together with NPI status and Medicare enrollment, and gives you a CSV to keep as a record of the check. 100 free a day with a free account, then from $5 for 5,000.
Data
The full OIG LEIE file, reloaded every month after OIG publishes it.