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.
This is a problem because, without a separate State sanction or exclusion list, it is difficult to determine if an individual or entity has been excluded or terminated based on State laws.
A State might exclude a party for failing to pay State taxes or a variety of other reasons that would not be valid bases for federal exclusion.
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 on violation of federal laws and post it to the LEIE.
States may also maintain their list as a central registry for state sanctions, which include other non-healthcare actions and exclusions or terminations.
For example, federal exclusions can be imposed for failing to repay federal loans, and it would be reasonable for a State to have a similar exclusion basis.
Why don’t some States have an Exclusion List?
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, the State agencies responsible for contracting may have a separate debarment list; the agency responsible for providing services to those in need of care may maintain a list of persons that cannot participate; or the State Department of Health might have a list, and so on.
How are the State Exclusion Lists different from the OIG Exclusion List?
One difference is that some State lists don’t exclusively contain healthcare sanctions. They are a centralized list for several sanctions, each of which may have a different impact. This is similar to System for Award Management (SAM) at SAM.gov, which includes debarments other than healthcare.
The other and more important difference is that federal exclusion lists do not post state exclusions, and so the State list is where to find exclusions based on violation of State Laws.
Do all State Exclusion Lists include the same information and in the same format?
No.
You’d think we would have a standard for something this important, but sadly, no.
Some lists are in Excel format, others in Word or PDF, and others are just 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 imports all of the State Exclusion Lists when they become available each month, so the database is always up to date. We aggregate and normalize the data and match it with the Healthcare Providers’ Profile as Exact or Possible matches, greatly simplifying your research.