How often should you check the OIG exclusion list?

Last updated 2026-11-09 · Starry Night

Short answer: before you hire or contract with someone, and then monthly. The longer answer is worth knowing, because the monthly cadence comes from OIG guidance and from a rule that applies to state Medicaid agencies, not from a federal rule written for every provider.

What OIG says

OIG's Updated Special Advisory Bulletin on the Effect of Exclusion (May 8, 2013) has a section titled "Frequency of Screening". It says providers should check the LEIE before employing or contracting with someone and periodically after that, and then:

"Because there is no statutory or regulatory requirement to check the LEIE, providers may decide how frequently to check the LEIE. OIG updates the LEIE monthly, so screening employees and contractors each month best minimizes potential overpayment and CMP liability."
OIG's Updated Special Advisory Bulletin on the Effect of Exclusion (May 8, 2013), p. 15

So monthly is OIG's recommendation, tied to the fact that new exclusions are added every month. OIG's FAQ says the LEIE is generally updated by the middle of each month with all actions taken in the prior month (its quick tips page says by the 10th). A check run in the second half of the month usually picks up the newest file; the downloads page shows the date of the last update.

What the regulation says, and who it binds

42 CFR 455.436 is a CMS rule for state Medicaid agencies. It requires the state agency to confirm the identity and exclusion status of enrolled providers and of people with an ownership or control interest, agents and managing employees, and to:

"Check the LEIE and EPLS no less frequently than monthly."
42 CFR 455.436(c)(2)

EPLS was the federal debarment list; the bulletin notes it was merged into SAM, and it is now part of SAM.gov. The bulletin adds useful context in its footnote 27: when CMS issued the rule in 2011, it clarified that the rule does not mandate that states require their providers to screen employees and contractors monthly, but recommended that states consider making it a requirement. The bulletin also notes a 2009 CMS letter to state Medicaid directors (SMDL #09-001) recommending that states require providers to screen employees and contractors monthly.

In practice, then, whether you must screen monthly depends on your state Medicaid program's rules and your provider or managed care contracts. Check those documents for the screening duties and frequency they set, including any duty to check the state's own list.

Medicare Advantage and Part D work is the other common source of a monthly duty. CMS's compliance program guidelines for plan sponsors (Medicare Managed Care Manual chapter 21, section 50.6.8) say sponsors must review the LEIE and the GSA list before hiring or contracting with any new employee, temporary employee, volunteer, consultant, governing body member or first tier, downstream or related entity (FDR), "and monthly thereafter". If your practice or agency contracts with a plan sponsor, the sponsor's contract may pass that check down to you; read it for the exact terms.

Who to include

OIG's bulletin recommends reviewing each job category and contract and asking whether the work is payable, directly or indirectly, in whole or in part, by a federal health care program. If yes, screen everyone in it. That usually includes:

• clinical staff, and also front desk, billing, coding, IT, HR and management roles: the bulletin says excluded people may not provide administrative and management services payable by the programs, even when those services are not separately billed;
• contractors and their employees: staffing agency nurses, contracted physician groups, billing and coding companies;
• volunteers and non-employed medical staff, whom the bulletin names explicitly;
• vendors and business owners, where they furnish payable items or services.

A simple monthly routine

1. Keep one roster of people and businesses to screen, with former names, state and NPI where you have them.
2. Screen new hires and new contractors before they start.
3. Once a month, after OIG's mid-month update, screen the whole roster against the LEIE and the state lists that apply to you.
4. Verify every possible match on OIG's online search with the SSN or EIN, and the state-list matches with the state agency.
5. File a dated record of the run and the review. See what to keep on file.

Checking a few names while you work in Claude? The free Healthcare Exclusion Lookup connector screens names or NPIs against the LEIE from a chat. No sign-up with Starry Night is needed.

Monthly narrows the gap; it does not close it

An exclusion can take effect between two monthly checks, and a name search can miss someone listed under a former name. Monthly screening narrows the window; it does not close it. Screening also covers only the lists you check, so add state Medicaid lists and SAM.gov where they apply.

Questions

Is monthly OIG exclusion screening required by law?

Not for providers by federal statute or regulation, according to OIG's 2013 bulletin, which says providers may decide how often to check. OIG says monthly checks best minimize overpayment and CMP liability. State Medicaid agencies must check the LEIE monthly under 42 CFR 455.436, and some states pass screening duties to providers through their own rules or provider agreements. CMS's compliance guidelines for Medicare Advantage and Part D sponsors call for a monthly LEIE check of their employees and contractors.

When does OIG update the LEIE?

Monthly. OIG's FAQ says the LEIE is generally updated by the middle of each month with all actions taken during the prior month.

Should contractors and staffing agency workers be screened?

OIG's 2013 bulletin recommends screening contractors using the same analysis as employees, and names staffing agency nurses, contracted emergency room physician groups and billing or coding contractors as examples. A provider can rely on a contractor's screening but OIG recommends validating it, for example by requesting and keeping the contractor's screening documentation.

This guide explains public rules and OIG guidance in plain English. It is not legal advice; for a decision about a specific person or claim, talk to your health care counsel. Healthcare Exclusion Lookup is published by Starry Night and is not affiliated with HHS-OIG, CMS or any state agency.