The Office of Inspector General (OIG) Exclusion List is a tool used to ensure that individuals or entities who are excluded from participating in federal healthcare programs are not hired or engaged by healthcare providers, suppliers, or contractors. The OIG Exclusion List is maintained by the OIG, which is part of the Department of Health and Human Services (HHS). Checking this list is part of our national criminal background check.
The OIG Exclusion List, also known as the List of Excluded Individuals/Entities (LEIE), contains the names of individuals and entities that have been excluded from participating in federal healthcare programs, such as Medicare and Medicaid. The list includes individuals and entities who have been convicted of healthcare-related crimes, such as fraud or abuse, or who have been found to have violated certain program requirements. The list ensures that those who have committed healthcare-related crimes are not able to continue participating in these programs and receiving payment for services they provide.
There are two types of exclusions: mandatory exclusions and permissive exclusions. Mandatory exclusions are required by law and apply to individuals and entities who have been convicted of certain crimes, such as patient abuse or neglect, or who have had their healthcare licenses revoked or suspended. Mandatory exclusions can last for a minimum of five years and can be extended based on the severity of the offense.
Permissive exclusions, on the other hand, are discretionary and apply to individuals and entities who have engaged in certain prohibited conduct, such as submitting false claims to Medicare or Medicaid. Permissive exclusions can last for a maximum of three years and can be extended based on the severity of the offense.
Employers in the healthcare industry are required to check the OIG Exclusion List before hiring or engaging individuals or entities to confirm that they are not on the list. Hiring someone on the OIG Exclusion List can result in severe penalties, including fines, exclusion from federal healthcare programs, and even criminal charges.
The OIG Exclusion List is available online and can be accessed through the OIG’s website. Employers can search the list by name, business name, or other identifying information to determine if an individual or entity is excluded from participating in federal healthcare programs. It may also be included as part of a background check package, for example in SentryLink’s background check.
It’s important to note that checking the OIG Exclusion List is not a one-time event. Employers in the healthcare industry are required to check the list regularly, as individuals or entities can be added to the list at any time. Employers can also subscribe to the OIG’s LEIE database to receive updates on additions or removals from the list.
In addition to checking the OIG Exclusion List, employers in the healthcare industry are also required to conduct other background checks, such as criminal history and employment verification checks, to ensure that individuals or entities are qualified and eligible to work in healthcare.