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Search for exclusions for Healthcare Providers by NPI number, Provider/Entity Name, Address, City, State, and Zip code.
An excluded individual or entity is ineligible to receive federal contracts, certain subcontracts, or financial and non-financial assistance and benefits.
Avoid potential Civil Monetary Penalties (CMP) with HealthProviders DB automated exclusion monitoring.
Federal database check regulations
The Federal Database Checks regulations — 42 CFR Part §455.436 mandate that State Medicaid Agencies must:
(a) Confirm the identity and determine the exclusion status of providers and any person with an ownership or control interest or who is an agent or managing employee of the provider through routine checks of Federal databases.
(b) Check the Social Security Administration’s Death Master File, the National Plan and Provider Enumeration System (NPPES), the List of Excluded Individuals/Entities (LEIE), the System for Award Management (SAM), and any such other databases as the Secretary may prescribe.
(c)(1) Consult appropriate databases to confirm identity upon enrollment and re-enrollment; and
(c)(2) Check the LEIE and SAM no less frequently than monthly.
Who needs to be screened?
Healthcare organizations must screen new hires and regularly monitor current employees, as well as the individuals and entities with whom they do business, to avoid potential Civil Monetary Penalties.
This includes doctors, nurses, pharmacists, and other healthcare professionals interacting with patients and federal healthcare programs, such as Medicare or Medicaid.
Even if someone isn’t directly providing care, they might still be involved in billing, patient records, or managing payments from federal programs. These roles are critical, and OIG exclusion checks should apply here.
Think of anyone supplying medical equipment, pharmaceuticals, or services to a healthcare organization. Just because someone isn’t a full-time employee doesn’t mean they shouldn’t be checked. They must pass an OIG background check if they provide goods or services involving federal funds.
Volunteers can be involved in patient care or sensitive healthcare operations in specific settings. While not always required, screening volunteers can help ensure the organization maintains compliance with federal regulations.