The OIG List of Excluded Individuals and Entities (LEIE) is a searchable federal database, maintained by the Office of Inspector General at the Department of Health and Human Services, of every person and organization currently barred from participating in Medicare, Medicaid, and other federally funded healthcare programs. If you bill these programs, work for an organization that does, or order items and services paid for with federal healthcare dollars, this list matters to you. Hiring or contracting with someone on it can trigger civil penalties exceeding $25,000 per claim, plus additional assessments and the risk of exclusion for your organization.
Who Ends Up on the List
The OIG places people and entities on the LEIE under two kinds of authority: mandatory and permissive.
Four categories of conduct trigger a mandatory exclusion, with no discretion for the OIG to decline:
- A criminal conviction related to delivering an item or service under Medicare or a state healthcare program.
- A criminal conviction for patient abuse or neglect during the delivery of healthcare.
- A felony conviction for fraud, theft, embezzlement, or other financial misconduct connected to any government-funded healthcare program.
- A felony conviction for unlawfully manufacturing or distributing a controlled substance.
Each mandatory exclusion carries a minimum five-year period.1Office of the Law Revision Counsel. 42 USC 1320a-7 – Exclusion of Certain Individuals and Entities From Participation in Medicare and State Health Care Programs A second mandatory-exclusion offense pushes the minimum to ten years, and a third results in permanent exclusion.2Office of Inspector General. Background Information and Exclusion Authorities Aggravating factors, such as government losses over $50,000, misconduct lasting more than a year, prior offenses, or significant patient harm, can extend the period beyond the floor.3eCFR. 42 CFR 1001.102 – Length of Exclusion
Permissive exclusions are discretionary. The OIG weighs the facts of each case. Common grounds include misdemeanor healthcare fraud convictions, misdemeanor controlled substance convictions, license revocation or suspension for reasons tied to competence or integrity (including surrendering a license during a pending disciplinary proceeding), furnishing unnecessary or substandard care, and defaulting on federally funded health-professions education loans. The baseline for a permissive misdemeanor fraud exclusion is three years, adjustable up or down based on the circumstances.4eCFR. 42 CFR Part 1001 Subpart C – Permissive Exclusions
What an Exclusion Actually Blocks
Once a person or entity is on the LEIE, no federal healthcare program will pay for any item or service they furnish, order, or prescribe. The payment ban covers every reimbursement method: itemized claims, cost reports, fee schedules, and prospective payment.5Office of Inspector General. Special Advisory Bulletin on the Effect of Exclusions From Participation in Federal Health Programs
The reach is wider than direct patient care. An excluded individual cannot hold any position at a healthcare organization if their salary, expenses, or fringe benefits are paid with federal program dollars. That covers administrative and management roles with no patient contact. According to the OIG, the practical effect is often to preclude employment of an excluded individual in any capacity at a provider that receives federal healthcare reimbursement.5Office of Inspector General. Special Advisory Bulletin on the Effect of Exclusions From Participation in Federal Health Programs
An organization can employ an excluded individual only if it pays that person entirely from private or other non-federal sources and the work relates solely to non-federal-program patients.5Office of Inspector General. Special Advisory Bulletin on the Effect of Exclusions From Participation in Federal Health Programs For most healthcare employers, that carve-out is nearly impossible to keep clean in practice.
Penalties for Hiring or Contracting With an Excluded Person
Providers that employ or contract with someone on the LEIE face civil monetary penalties of up to $20,000 for each item or service the excluded person furnishes that appears on a claim to a federal program, plus an assessment of up to three times the amount claimed.6Office of the Law Revision Counsel. 42 USC 1320a-7a – Civil Monetary Penalties Those statutory amounts are adjusted for inflation each year; the 2025 inflation-adjusted ceiling is $25,595 per item or service.7Federal Register. Annual Civil Monetary Penalties Inflation Adjustment The employing organization can itself be excluded on top of the financial penalty.
These penalties apply even when the provider did not actually know the person was excluded, as long as it should have known. That “should have known” standard is why routine screening matters. The OIG recommends that healthcare entities routinely check the LEIE for new hires and current employees.8Office of Inspector General. Exclusions Most compliance programs read “routinely” as monthly, and monthly has become the industry standard.
How to Search the LEIE
The OIG’s search portal at oig.hhs.gov/exclusions lets you look up any individual or entity by name. A name search is only the start. To match a common name to the right person, you also need a Social Security Number for an individual or an Employer Identification Number for an entity.9Office of Inspector General. LEIE Help
After entering a name and clicking Search, the system either returns “No Results Found” or displays matching records. If a name matches, enter the SSN or EIN in the verification field and click Verify. That step either confirms or rules out an identity match. Skipping verification is a common mistake that leaves organizations exposed both to false-positive terminations and to false-negative dismissals of real matches.
The LEIE does not accept the National Provider Identifier for verification. SSN and EIN are the only identity fields the system will check.9Office of Inspector General. LEIE Help
Bulk Screening for Larger Organizations
Organizations screening many employees and contractors can download the full LEIE as a CSV file from the OIG’s website. The file contains every currently active exclusion and is replaced each month. If you keep a local copy, the OIG also publishes monthly supplement files listing new exclusions and recent reinstatements, so you can update without pulling the entire database again.10Office of Inspector General. LEIE Database and Supplement Downloads
Keep your downloaded file current. Screening against a stale file is functionally the same as not screening at all for anyone added since your last download.
The LEIE Is Not the Only Exclusion List
The LEIE contains only OIG exclusion actions. The System for Award Management (SAM.gov), run by the General Services Administration, tracks debarments across all federal agencies, including OIG exclusions and non-healthcare actions.11Office of Inspector General. Exclusions FAQs Someone could be debarred by another federal agency and appear in SAM but not the LEIE. Many state Medicaid programs require screening against both, and some states maintain their own exclusion databases as well. Checking both is the safer practice.
If You’ve Been Excluded: Appeals and Reinstatement
An excluded individual or entity has 60 days after receiving the exclusion notice to request a hearing before an Administrative Law Judge at the Departmental Appeals Board. The request must be in writing, signed by the excluded party or their attorney, and sent by certified mail. Receipt is presumed to occur five days after the notice date unless the excluded party can show otherwise.12eCFR. 42 CFR Part 1005 – Appeals of Exclusions, Civil Money Penalties, and Assessments Missing that 60-day window effectively waives the right to ALJ review. The written request must identify the specific findings of fact and conclusions of law in dispute and explain the basis for the disagreement.
An exclusion does not lift on its own when the term ends. The excluded party must apply for reinstatement and receive written approval from the OIG before resuming any federal healthcare program activity. Billing or furnishing services before that written notice arrives can trigger further penalties.
A party with a defined exclusion period may apply for reinstatement no earlier than 90 days before the exclusion’s expiration date. Anything submitted sooner will not be considered.13Office of Inspector General. Applying for Reinstatement Requests go to the OIG’s Exclusions Branch by email or standard mail, and there is no guaranteed processing timeline, so filing early in the 90-day window leaves room for delays.14Office of Inspector General. About Reinstatements
If You Discover You’ve Been Employing an Excluded Person
Organizations that discover an excluded employee or contractor have an option beyond waiting for the OIG to find out. The Provider Self-Disclosure Protocol lets healthcare entities voluntarily report the violation, which typically produces better outcomes than a government-initiated investigation.15Office of Inspector General. Health Care Fraud Self-Disclosure
One concrete benefit: when an entity self-discloses employment of an excluded individual, the OIG reduces the damages calculation by the entity’s federal payor mix, recognizing that not every dollar earned by the excluded person was tied to federal program patients. This reduction is specific to excluded-individual cases and does not apply to self-disclosures involving unlicensed individuals.15Office of Inspector General. Health Care Fraud Self-Disclosure
Self-disclosure is not a shield against all penalties, but it consistently produces better results than getting caught. If you learn that an employee is on the LEIE, cut off their access to federal program work immediately and talk to counsel about whether to file a self-disclosure.