Healthcare Exclusion Lookup

How to check the OIG exclusion list, step by step

Last updated · Starry Night

The List of Excluded Individuals/Entities (LEIE) is HHS-OIG's list of people and businesses currently excluded from Medicare, Medicaid and other federal health care programs. Checking it is a name search followed, for any possible match, by an identity check. This guide walks through both, using OIG's own instructions.

What the list is, and why employers check it

Under 42 CFR 1001.1901(b), no federal health care program pays for items or services furnished by an excluded person, or at the direction or on the prescription of an excluded physician when the person furnishing them knew or had reason to know of the exclusion. OIG's Updated Special Advisory Bulletin on the Effect of Exclusion (May 8, 2013) explains that the ban reaches well beyond doctors: it covers nurses, pharmacy staff, billing and coding, administrative and management roles, and volunteers whose work is payable directly or indirectly by those programs. That is why practices, pharmacies, home health agencies and staffing firms check the list before hiring and on a schedule after that.

Two ways to search

OIG offers two formats, described in its exclusions FAQ and LEIE quick tips:

For a handful of new hires, the online search is enough. For a full roster, see screening many names with the download file.

Step by step

  1. Gather every name a person has used. The LEIE holds the name known to OIG at the time of exclusion. OIG's tips say to check former names (maiden or previous married names) and to search a hyphenated surname under each part: Jane Smith-Jones under Jane Smith and Jane Jones as well.
  2. Search with short name fragments. OIG recommends entering only the first few letters of the first and last names, or the first part of a business name, and including punctuation such as the apostrophe in O'Connor. A business search matches from the start of the name, so "dental" finds DENTAL CARE UNLIMITED but not UNITED DENTAL CARE; try the distinctive word too.
  3. Review each result. Compare the listed name, state, specialty and date of exclusion with what you know about the person. A common name can return several records.
  4. Verify any possible match. On the online search, open the result and use Verify with the person's SSN or the business's EIN. OIG's tips are direct about this step:
"It is not sufficient to simply find a matching first and last name on the LEIE."
HHS-OIG, LEIE Quick Tips
  1. Print or save the result. OIG says to use the Print Search Results button, because the browser's print function will not work on that page, and to keep documentation of the name search and any follow-up searches. More on this in what to keep on file.
  2. Repeat on a schedule. OIG adds new exclusions every month. See how often to check.

What the LEIE does not cover

If you find a possible match

Do not treat a name match as a finding. Verify it with the SSN or EIN first. If the match is confirmed for someone already working with you, OIG's FAQ points to its guidance on the effect of exclusion and, for people you already employ, to its Self-Disclosure Protocol. What happens if you employ an excluded individual covers this in more detail.

Doing it faster

Checking a whole roster?

The screening record page screens up to 500 names at once against the LEIE and 11 state Medicaid lists (NY, CA, TX, MI, GA, MD, LA, AR, KY, NC, WA), with name matching that handles word order, middle names, nicknames and small typos, and builds a dated PDF record of the run. On-screen results and a PDF marked PREVIEW are free; a $19 one-time unlock removes the watermark for 24 hours. Names are not stored.

Screen a list

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.

Either way, the identity check stays with OIG: any possible match from a name search, ours included, should be confirmed on OIG's online search.

Questions

Is it free to check the OIG exclusion list?

Yes. OIG's online search and its downloadable LEIE file are free and need no account.

Does the LEIE download file include Social Security numbers?

No. OIG says the Privacy Act prohibits distributing SSNs, so the download file has none. To confirm a possible match with an SSN or EIN, use the verify step on OIG's online search.

Does a matching name mean the person is excluded?

No. OIG's tips say it is not sufficient to find a matching first and last name; you verify identity with an SSN for a person or an EIN for a business on OIG's online search.

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.

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