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United States federal healthcare programs · U.S. federal exclusion program

HHS OIG List of Excluded Individuals/Entities

OIG publishes exclusion information and monthly LEIE data. Name or identifier matching requires care, and the official program record and facts must be reviewed before an organization takes action.

What the authority record establishes

OIG publishes exclusion information and monthly LEIE data. Name or identifier matching requires care, and the official program record and facts must be reviewed before an organization takes action.

Exclusion effects arise under applicable federal authorities and program rules

The exact official title, issuing body, jurisdiction, version or application record, and linked source define the scope of this page. Readers should not transfer the authority's status to a commercial product or infer transaction-, patient-, system-, site-, or organization-specific applicability from this summary.

Why it matters to this market

Exclusion screening is an ongoing identity and evidence workflow, not a one-time checkbox. Systems need source dates, matching logic, potential-match review, resolution, and downstream action records.

Affected operating stages

  • Pre-Engagement Screening
  • Credentialing
  • Enrollment
  • Ongoing Monitoring
  • Potential-Match Investigation
  • Evidence Retention

Capabilities to examine

Sanctions, Exclusions, And Adverse-Action Monitoring

Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for sanctions, exclusions, and adverse-action monitoring.

NPI, Taxonomy, And Identity Resolution

Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for NPI, taxonomy, and identity resolution.

Provider Affiliations And Locations

Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for provider affiliations and locations.

APIs, Integration, And Downstream Data Distribution

Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for APIs, integration, and downstream data distribution.

Audit Trail, Source Provenance, And Committee Evidence

Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for audit trail, source provenance, and committee evidence.

Analytics, Turnaround, And Operational Reporting

Ask how the system or service identifies the controlling source and version, applies customer-specific interpretation, handles exceptions, preserves human judgment, and retains evidence for analytics, turnaround, and operational reporting.

Affected buyer audiences

  • healthcare employers and contractors
  • credentialing and enrollment teams
  • health plans
  • compliance and program integrity teams
  • monitoring and screening organizations

Implementation questions

  • Which entities, products, populations, transactions, systems, sites, or jurisdictions are actually within scope?
  • What is binding, what is guidance, and what is a technical or consensus standard?
  • Which publication, adoption, effective, application, transition, and enforcement dates differ?
  • Who owns legal, clinical, quality, regulatory, policy, or operational interpretation?
  • How will a source revision affect open work and historical decisions?

Interpretation boundary

A potential match is not a final exclusion determination. Organizations must use official verification procedures and qualified review.