Quickly search the SAM Exclusions, OIG Exclusions, and all State Medicare Exclusions Lists at once, greatly simplifying your monthly Exclusions Monitoring and Screening requirements.
The System for Award Management Exclusions (SAM.gov) is imported monthly as it becomes available, so the Healthcare Provider Profiles are always up to date.
Enter an NPI number, license number, or provider name in the search field below to search SAM Exclusions.
Alternatively, you can also search the Provider Profiles.
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.
- Avoid Civil Monetary Penalties.
- Continuous Monitoring of OIG Exclusions, SAM Exclusions, and all State Medicare Exclusion Lists updated monthly.
- Comprehensive and audit-ready 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
Looking for a fully automated monthly screening solution? Take a look at our Monthly Exclusion Monitoring subscription.
Frequently Asked Questions
Requirement
Federal database checks—42 CFR Part § 455.436 requires all Medicare Advantage Plans, all State Medicaid Programs, and all Medicaid Managed Care Organizations to confirm through routine Federal database checks the exclusion status of providers.
Compliance
The Office of Inspector General (OIG) mandates screening to prevent fraud, abuse, and patient neglect.
Financial Risk
Hiring an excluded individual can result in substantial Civil Monetary Penalties (CMPs) and repayment obligations.
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 to “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.
Healthcare organizations must conduct exclusion screening for all individuals and entities that provide items or services payable by federal health care programs.
This requirement applies to anyone whose work supports services reimbursed by Medicare or Medicaid—whether those services are provided directly or indirectly.
Healthcare Providers & Facilities
Hospitals, nursing homes, home health agencies, clinics, and physician practices.
Personnel
All employees (clinical and non-clinical), pharmacists, pharmacy staff, physicians, nurses, clinical staff, medical assistants, and administrative staff.
Contractors & Vendors
Third-party billing & coding services, transportation providers, ambulance services, and medical equipment suppliers.
Leadership & Support
Board members, managers, owners, and volunteers.
Basically, if an individual’s role contributes in any way to federally reimbursable services, that individual should be included in your OIG exclusion screening and Medicare exclusion monitoring process.
Furthermore, the OIG has emphasized that civil monetary penalties are most likely when excluded individuals provide essential services to patient care.
Learn more about who needs to be screened for Medicare Exclusion.
Federal database checks—42 CFR Part §455.436 regulations require State Medicaid agencies to do all the following:
(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.
Both OIG Exclusions and SAM Exclusions are required because they serve distinct, though overlapping, purposes in protecting federal funds and programs.
OIG (Office of Inspector General) exclusions target individuals/entities prohibited from participating in Medicare and Medicaid. Whereas, SAM (System for Award Management) debarments cover broader exclusions from all federal contracts, grants, and loans.
Different Scope & Authority
OIG focuses on healthcare fraud/patient harm. SAM covers a wider range of actions, including non-healthcare fraud, tax delinquency, and national security violations.
No One-to-One Overlap
An individual might be excluded from Medicare by the OIG but not yet listed in SAM, or vice versa (e.g., a contractor debarred from federal construction projects for fraud who then applies to a clinic).
Legal Compliance and Penalties
Federal law prohibits using federal funds (Medicare/Medicaid) to pay any excluded provider. Hiring or contracting with an entity listed on either database can result in severe civil monetary penalties (CMPs) and loss of funding.
Completeness
While the OIG’s List of Excluded Individuals and Entities (LEIE) is specific, SAM often includes actions from multiple federal agencies, making it a more comprehensive federal screening tool overall.
In short, auditing both databases is necessary to ensure complete compliance and avoid liability, as they are not always synchronized, and a “clean” record on one does not guarantee exclusion from the other.