OIG Archives

Medicaid Exclusions, Sanctions, Terminations – What’s the Difference?

February 15, 2025August 23, 2025

The differences between sanctions, exclusions, and termination are crucial for healthcare organizations to understand when hiring and retaining skilled professionals. Sanctions A sanction results from an administrative hearing where an individual or entity violates an administrative rule, civil law, or criminal offense, leading to various penalties. Sanctions are enforced by the Office of the Inspector General (OIG) or a State Medicaid program authority. A sanction from a healthcare disciplinary or licensing board can lead to significant consequences, the most severe of which is an exclusion. Exclusions An exclusion results from an extreme sanction issued by the Office of Inspector General (OIG). Exclusions areLearn MoreMedicaid Exclusions, Sanctions, Terminations – What’s the Difference?

OIG Self-Disclosure Protocol

December 12, 2024August 21, 2025

Why Self-Disclosure Is Important The OIG has long emphasized the importance of dealing with Federal healthcare programs with integrity. All healthcare industry members have a legal and ethical duty to do so. This duty includes an obligation to detect and prevent fraudulent and abusive activities, including implementing specific procedures and mechanisms to investigate and resolve instances of potential fraud involving the Federal health care programs. Whether as a result of voluntary self-assessment or in response to external forces, participants in the healthcare industry must be prepared to investigate such instances, assess the potential losses suffered by the Federal healthcare programs,Learn MoreOIG Self-Disclosure Protocol

Exclusion Lists FAQs

December 1, 2024August 17, 2025

Which exclusion list should I use to check employees and vendors, the OIG-LEIE or the GSA-SAM? It is recommended that you check both the Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) and the General Services Administration’s (GSA) System for Award Management (SAM) databases, as well as all of the publicly available State Exclusion Lists. According to 42 CFR Part §455.436(b) — Federal database checks, State Medicaid agencies must: (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 AwardLearn MoreExclusion Lists FAQs

OIG, SAM, and State Exclusion Lists – What’s the Difference

November 12, 2024September 4, 2025

You know it’s essential to screen new hires, current employees, and vendors against the Office of Inspector General (OIG) List of Excluded Individuals/Entities (LEIE), the General Services Administration (GSA) System for Award Management (SAM), and all available State Exclusion lists, but what’s the difference? HealthProviders DB is an unparalleled solution that allows users to effortlessly and simultaneously search OIG Exclusions, SAM Exclusions, State Exclusion Lists, FDA Debarment, and Clinical Investigators—Disqualification Proceedings—all in one powerful platform! The OIG List of Excluded Individuals and Entities (LEIE) The Office of Inspector General (OIG) maintains the List of Excluded Individuals/Entities (LEIE) that is updatedLearn MoreOIG, SAM, and State Exclusion Lists – What’s the Difference

State Exclusion List FAQs

November 12, 2024August 22, 2025

Why do States have an Exclusion List? 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. It can take several months for the OIG to process the State-reported sanction and determine if the OIG will also impose a federal exclusion based onLearn MoreState Exclusion List FAQs