Quickly search all State Exclusion Lists simultaneously, greatly simplifying your monthly Exclusions Monitoring and Screening requirements.
Providers excluded by the OIG or terminated by a State Medicaid Agency cannot participate in federally funded healthcare programs. This includes Medicaid, TRICARE, and the Children’s Health Insurance Program (CHIP). Additionally, the Centers for Medicare & Medicaid Services (CMS) can revoke billing privileges, prohibiting the provider from participating in Medicare.
Providers are liable for overpayments made for any items or services provided by any excluded person for which the provider received reimbursement from federal healthcare programs. Additionally, the provider may face Civil Monetary Penalties (CMP) if they fail to ensure that proper exclusion screening has been conducted.
HealthProviders DB is an extensive healthcare provider and exclusions database featuring over 9 million comprehensive Provider Profiles, updated daily!
All available State Exclusion Lists are imported monthly as they become available, keeping the Healthcare Provider Profiles up to date.
Enter an NPI number, license number, or provider name in the search field below to search OIG Exclusions, SAM Exclusions, and all State Exclusions lists at once.
Alternatively, you can also search the Provider Profiles.
To filter by state, select it from the list below. Additionally, you can narrow the list by city, among other options, from the Filter Panel. Click the vertical ellipses ⋮ in the upper-right to open the filter panel.
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Save Time & Money and Take the Stress out of Exclusions Screening
- Make your life easier and save hours on manual exclusion checks!
- Maintain compliance with federally funded healthcare programs.
- Prevents potential costly Civil Monetary Penalties.
- Efficiently batch Screen against OIG Exclusions, SAM Exclusions, & all State Exclusions Lists at once.
- Comprehensive Exclusions Report.
Just $25 / 100 Providers Screened
No registration or user account required
Who should be screened for OIG Exclusions?
Why Screen both OIG Exclusions and SAM Debarments
Exclusions, Terminations, & Debarments Understanding the Difference
Frequently Asked Questions
States are required to notify the Health and Human Services (HHS) Office of Inspector General (OIG) only when they exclude or terminate an individual or entity based on federal law.
States are not required to notify the OIG (nor should they) of actions based on State laws because if the sanction fails to meet the criteria for a federal exclusion, the exclusion will not be posted on the LEIE.
Plus, it can take several months for the OIG to process the State-reported sanction, determine whether it will also impose a federal exclusion based on a violation of federal laws, and post it to the LEIE.
For instance, a State might exclude a party for failing to pay State taxes or for other reasons that would not be valid bases for federal exclusion. For this reason, states maintain a list of individuals and entities who are terminated, suspended, sanctioned, or otherwise excluded from the State Medicaid program under State law.
The key difference is that federal exclusion lists do not include state exclusions; thus, the State list is where to find exclusions based on violations of State laws.
Another difference is that some State lists don’t exclusively contain healthcare sanctions. They are a centralized list of several sanctions, each with a different impact. This is similar to the System for Award Management (SAM), which includes debarments beyond the healthcare sector.
States aren’t required to maintain a State exclusion list, and seven states have elected not to: New Mexico, Oklahoma, Rhode Island, South Dakota, Utah, Virginia, and Wisconsin.
These states may have other sanction lists. For example, State agencies responsible for contracting may maintain a separate debarment list; the agency responsible for providing services to those in need of care may maintain a list of individuals who cannot participate; or the State Department of Health might maintain its own list, and so on.
You’d think we would have a standard for something this important, but sadly, no.
Unfortunately, each State that publishes an exclusion list uses a different format and varies in level of detail.
Some lists are in Excel format, others are in Word or PDF, and some are simply HTML web pages.
Information available in State Exclusion Lists can also vary widely, with some that include little more than a name and address.
HealthProviders DB is a comprehensive national database that consolidates all State Medicaid Exclusion Lists to ensure you have access to the most up-to-date and accurate information available.
Section 6501 of the Affordable Care Act (ACA), Termination of Provider Participation Under Medicaid if Terminated Under Medicare or Other State Plan, requires State Medicaid programs and the Children’s Health Insurance Program (CHIP) to terminate the participation of any individual or entity that has been terminated from Medicare or any other State’s Medicaid program for cause.
This provision is intended to enhance program integrity by ensuring that federal funds do not reach providers excluded for serious offenses, such as fraud or abuse, regardless of the originating State’s termination.
However, a terminated provider could still work at healthcare organizations if they don’t provide services that are billable to Medicare. If they don’t bill Medicare directly for their services, they can still work in administrative roles at healthcare organizations.
For instance, a nurse practitioner who has been terminated (but not excluded) from Medicare could take on a different position at a hospital, as long as the services provided are not directly billable to Medicare.
According to the OIG’s Special Advisory Bulletin issued in May 2013, the OIG recommends that healthcare organizations check their employees and contractors against the LEIE monthly.
42 CFR Part § 455.436(c)(2) Federal database checks states, “check the LEIE and SAM no less frequently than monthly.”
Monthly screening is mandatory in at least 14 States, while many others strongly recommend that providers screen employees and vendors against their State lists and the LEIE monthly.