90 added
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Original
2026-01-01
Modified
2026-02-28
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<h2>Join 100,000+ employers running faster background checks with Checkr</h2>
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<h2>Start running business background checks</h2>
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<p>Not an employer? Run a background check on yourself<a>here ></a></p>
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<p>Order personal background checks<a>here ></a></p>
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<p>Conducting an OIG background check for employment can help<a>healthcare employers</a>mitigate risk, meet industry requirements, and provide quality patient care. An OIG background check searches the OIG exclusion list for individuals or entities banned from participating in federally funded healthcare programs. Organizations that hire employees or contractors on the OIG exclusion list can lose their eligibility for Medicare, Medicaid, and other federal healthcare programs, and may also face sizable fines and penalties. However, employers must be careful to conduct their OIG background checks in compliance with applicable federal, state, and local laws.</p>
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<ul><li>OIG background checks compare people and entities against federal exclusion lists to determine whether they’re banned from participating in federally funded healthcare programs.</li>
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<p>An OIG background check is a<a>healthcare background screening</a>that searches the OIG exclusion list for individuals or providers barred from participation in federally funded healthcare programs. How does someone get on the OIG exclusion list? Suspended licenses, financial fraud, and patient abuse or neglect are among the reasons a person or organization may be placed on the exclusion list. Employers that hire employees, contractors, or others on this list may lose eligibility for funding from federal healthcare programs such as Medicare and Medicaid. They may also have to pay civil penalties up to tens of thousands of dollars.</p>
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<li>The primary source is the OIG's List of Excluded Individuals and Entities (LEIE), with related checks often run against the System of Award Management (SAM)</li>
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<p>Healthcare industry employers check the OIG exclusion list to help enhance patient care, hire qualified candidates, and maintain their federal funding eligibility. Employers can check the OIG exclusion list online or work with a qualified background check provider, like Checkr, to conduct a comprehensive<a>OIG criminal background check</a>.</p>
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<li>Exclusions are categorized as mandatory or permissive under federal law</li>
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<p>Healthcare workers or contractors who typically undergo OIG background screenings include:</p>
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<li>Healthcare organizations apply screening upon hiring and on a recurring cadence based on policy and regulation</li>
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<ul><ul><li><p>Physicians</p>
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</ul><p>An OIG background check is a screening process that searches federal exclusion databases to determine whether healthcare workers, contractors, and vendors are barred from participating in federally funded healthcare programs.</p>
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</li>
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<p>The OIG exclusion list-formally called the List of Excluded Individuals and Entities (LEIE)-is the official database of individuals and entities excluded from Medicare, Medicaid, and other federal healthcare programs. The<a></a><a>US Department of Health and Human Services</a>maintains this database and updates it each month.</p>
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<li><p>Nurses</p>
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<p>Exclusion means the person or entity cannot bill or participate in federal healthcare programs. The LEIE includes exclusions for offenses such as healthcare fraud, patient abuse or neglect, and certain licensing violations.</p>
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</li>
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<p>The Office of Inspector General (OIG) oversees program integrity and enforces exclusions that apply to Medicare, Medicaid, and other federal healthcare programs. OIG screening differs from standard<a></a><a>criminal background checks</a>because it focuses specifically on healthcare program exclusions rather than general criminal history.</p>
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<li><p>Technicians</p>
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<p>Organizations that employ excluded individuals risk losing their ability to receive Medicare and Medicaid payments. Generally, it’s recommended that employers search the OIG exclusion list monthly since it’s updated on a monthly cadence. </p>
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</li>
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<p>Healthcare organizations often run both LEIE checks and SAM searches for more comprehensive compliance coverage.</p>
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<li><p>Certified nursing aides</p>
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</li>
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<li><p>Home health agency employees</p>
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</li>
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<li><p>Nursing home employees</p>
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</li>
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<li><p>Hospital employees</p>
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</li>
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<li><p>Emergency medical technicians (EMTs)</p>
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</li>
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<li><p>Paramedics</p>
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</li>
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<li><p>Ambulance drivers</p>
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</li>
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<li><p>Ambulance dispatchers</p>
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</li>
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<li><p>Pharmacists</p>
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</li>
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<li><p>Pharmacy employees who input prescription information</p>
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</li>
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<li><p>Administrative services employees</p>
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</li>
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<li><p>Individuals who sell or deliver medical devices or equipment</p>
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</li>
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<li><p>Social workers</p>
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</li>
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<li><p>Claims processors</p>
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</li>
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<li><p>Utilization reviewers</p>
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</li>
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<li><p>Billing agents</p>
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</li>
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<li><p>Accountants</p>
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</li>
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<li><p>Volunteers</p>
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</li>
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</ul></ul><p>The OIG exclusion list, formally known as the<a></a><a>List of Excluded Individuals/Entities</a>(LEIE), shows individuals and organizations banned from participating in federally funded healthcare programs, including Medicare and Medicaid. The US Department of Health and Human Services<a></a><a>Office of Inspector General</a>maintains the OIG exclusion list. Some OIG exclusions are mandatory; others, called permissive exclusions, are at the discretion of the OIG.</p>
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<h2>Join 100,000+ employers running faster background checks with Checkr</h2>
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<p>Not an employer? Run a background check on yourself<a>here ></a></p>
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<p>Under<a></a><a>Section 1128 of the Social Security Act</a>, the Department of Health and Human Services (HHS) is mandated to exclude individuals or organizations for the following causes:</p>
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<p>Under<a></a><a>Section 1128 of the Social Security Act</a>, the Department of Health and Human Services (HHS) is mandated to exclude individuals or organizations for the following causes:</p>
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<ul><ul><li><p>Medicare or Medicaid fraud</p>
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<ul><li><b>Area of focus:</b>Healthcare program exclusions</li>
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</li>
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<li><b>Use case:</b>Anyone who provides, bills, or supports federally reimbursed healthcare services</li>
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<li><p>Offenses related to delivery of services or items under Medicare, Medicaid, SCHIP, or state healthcare programs</p>
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<li><b>Update schedule:</b>Monthly</li>
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</li>
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<li><b>Common triggers:</b>Healthcare fraud, patient abuse, license revocation, kickback schemes</li>
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<li><p>Patient abuse or neglect</p>
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</ul><ul><li><b>Area of focus:</b>Federal contracting and government-wide debarments</li>
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</li>
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<li><b>Use case:</b>Organizations seeking federal contracts, grants, or subcontracts</li>
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<li><p>Felony convictions for healthcare-related theft, fraud, or other financial misconduct</p>
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<li><b>Update schedule:</b>Varies</li>
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</li>
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<li><b>Common triggers:</b>Contract fraud, government-wide debarment actions</li>
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<li><p>Felony convictions for unlawful manufacture, prescription, dispensing, or distribution of controlled substances</p>
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</ul><p>Healthcare organizations that also contract with federal agencies or receive grants typically check both databases to address healthcare program integrity and broader federal contracting requirements.</p>
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</li>
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<p>The<a></a><a>Social Security Act</a>defines two types of OIG exclusions based on the severity of the offense.</p>
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</ul></ul><p>Permissive exclusions are made at the discretion of HHS and may include:</p>
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<p>Mandatory exclusions are required by law for serious offenses and typically carry longer exclusion periods:</p>
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<ul><ul><li><p>Misdemeanor convictions related to healthcare fraud (other than Medicare or a state health program)</p>
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<ul><li>Felony healthcare fraud convictions</li>
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</li>
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<li>Patient abuse or neglect</li>
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<li><p>Fraud in a non-healthcare program funded by a federal, state, or local government agency</p>
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<li>Felony controlled substance offenses related to healthcare</li>
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</li>
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<li>Felony convictions for healthcare-related theft or financial misconduct</li>
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<li><p>Misdemeanor convictions for unlawful manufacture, distribution, prescription, or dispensing of controlled substances</p>
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</ul><p>Permissive exclusions are imposed at OIG's discretion for lesser violations:</p>
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</li>
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<ul><li>Misdemeanor fraud convictions</li>
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<li><p>A suspended, revoked, or surrendered license to provide healthcare</p>
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<li>License suspension, revocation, or surrender</li>
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</li>
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<li>Quality-of-care violations</li>
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<li><p>Submitting false or fraudulent claims to a federal healthcare program</p>
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<li>Submission of false claims to federal healthcare programs</li>
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</li>
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</ul><p>The duration of different exclusions varies significantly. Mandatory exclusions often last several years, while permissive exclusions may be shorter. Reinstatement is not automatic-excluded parties must apply to OIG and receive formal approval before resuming participation in federal healthcare programs.</p>
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<li><p>Participating in illegal kickback arrangements</p>
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<p>Healthcare organizations that bill Medicare, Medicaid, or other federal programs face significant risks when they employ excluded individuals. OIG verification helps organizations maintain their program eligibility and avoid costly penalties.</p>
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</li>
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<p>The<a>Centers for Medicare and Medicaid Services</a>expect healthcare providers to screen their workforces to prevent billing violations. This includes employees, contractors, vendors, and volunteers who may be involved in federally reimbursed services.</p>
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<li><p>Defaulting on a health education loan or scholarship</p>
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<p>Employing an excluded individual can result in substantial financial consequences:</p>
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</li>
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<ul><li><b>Civil monetary penalties:</b>Up to $10,000 per claim associated with an excluded individual's services</li>
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<li><p>Being the owner, officer, or managing employee of an entity that is sanctioned</p>
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<li><b>Repayment obligations:</b>Organizations may be required to return federal payments connected to the excluded person</li>
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</li>
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<li><b>False Claims Act exposure:</b>Additional liability when claims include specific services furnished, ordered, or prescribed by excluded parties</li>
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</ul></ul><p>Conducting OIG screenings can help healthcare employers maintain federal funding eligibility, improve patient care, and mitigate risk. For example,<a></a><a>OIG background checks for employment</a>can identify individuals whose licenses have been suspended or revoked, helping safeguard you from hiring unqualified employees. Conducting an OIG background check can also help protect employers from legal liability that could arise from hiring someone known to have abused patients or committed fraud.</p>
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<li><b>Program suspension:</b>Loss of billing privileges and undergoing mandatory corrective actions</li>
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<p>Employing an individual, volunteer, or entity on the OIG exclusion list could expose your organization to civil monetary penalties of as much as $10,000 per day that the excluded individual or entity is employed. There may also be penalties of up to $10,000 for each claimed item or service provided, subject to an assessment of up to three times the amount of each claimed item or service. In addition, you could lose your ability to accept federal healthcare program funding such as Medicare and Medicaid payments.</p>
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</ul><p>Regular exclusion screening helps prevent individuals with histories of fraud, abuse, or serious professional misconduct from affecting patient care or billing operations. This reduces the risk of harm and maintains credibility with patients, payers, and regulators.</p>
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<p>Although OIG background checks for employment can be vital to protecting your organization and your patients, it’s important to follow all applicable federal, state, and local laws when conducting your background screenings.</p>
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<p>Federal regulations and compliance guidance establish expectations for initial and ongoing exclusion screening. Healthcare organizations typically develop screening policies that align with regulatory requirements and the update schedules of exclusion databases.</p>
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<h2>Join 100,000+ employers running faster background checks with Checkr</h2>
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<p>Section 1128 of the Social Security Act authorizes OIG to exclude individuals and entities from federal healthcare programs. The law defines mandatory and permissive exclusion categories and establishes that claims tied to services furnished, ordered, or prescribed by excluded parties are not payable under federal healthcare programs.</p>
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<p>Not an employer? Run a background check on yourself<a>here ></a></p>
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<p>Covered entities-including providers, suppliers, managed care organizations, and their contractors-carry responsibility for screening to avoid employing or contracting with excluded parties.</p>
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<p>You can conduct OIG background checks by<a></a><a>searching the OIG Exclusions database</a>or working with a trusted consumer reporting agency (CRA) to handle the search for you. Employers who choose the do-it-yourself option will need the individual’s Social Security number (SSN) or the entity’s Employer Identification Number (EIN).</p>
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<p>When using third-party screening services for<a></a><a>employment background checks</a>, employers must follow the<a>Fair Credit Reporting Act</a>(FCRA). This includes providing disclosures, obtaining authorization from candidates to run a background check, and following adverse action procedures if screening results influence employers’ hiring decisions.</p>
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<p>When performing an OIG background check for five or fewer individuals or organizations, you can<a></a><a>search the OIG Exclusions list online</a>. Employers who are screening large numbers of individuals or entities at once may find it easier to<a></a><a>download the OIG LEIE database</a>. However, the downloaded database doesn’t include SSNs or EINs, which can make accurately verifying results challenging, and the interface can be unwieldy. With either search method, it’s important to search under all the names and name variations a person or organization may have.</p>
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<p>Guidance from the<a>Equal Employment Opportunity Commission</a>(EEOC) also applies to ensure screening practices are consistent, job-related, and non-discriminatory. For example, only screening candidates of a specific race or gender would be considered discriminatory; however, running driving record checks on all candidates considered for a driving role would be job-related and consistent.</p>
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<p>The OIG exclusion list is updated once per month based on information provided by state exclusion lists. Because each state may send updates to HHS at a different time of the month, an individual or entity with healthcare sanctions or exclusions in their state may not appear on the OIG exclusion list immediately. For the most complete results, you may also want to check state Medicaid exclusion lists, which can be time-consuming. HHS also recommends checking the OIG exclusion list monthly to ensure you have the most current data. Employers can do this by checking the LEIE manually each month or requesting email notifications whenever the list is updated.</p>
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<p>Many states maintain separate Medicaid exclusion lists in addition to federal sources. Multi-state healthcare employers typically include relevant state lists alongside the LEIE and SAM in their screening programs.</p>
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<p>In addition to the OIG list and state exclusion lists, you may wish to check other federal databases listing exclusions, sanctions, and penalties, suspensions, or disciplinary action that has been taken against an entity or individual. These include searching the System for Award Management (SAM), a database of federal contractors maintained by the U.S. General Services Administration (GSA). An OIG SAM background check can show whether a contractor is excluded from working with the federal government.</p>
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<p>Healthcare employers can perform OIG checks through manual database searches or professional screening services. Here's the step-by-step process:</p>
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<p>Enlisting a CRA, like Checkr, to perform an OIG check can streamline your healthcare screening process and deliver faster, more accurate results compared to performing your own background checks. Checkr’s built-in compliance tools help you create customized workflows tailored to any screening level your healthcare organization requires, with comprehensive OIG and GSA background checks that include searching the SAM database, the OIG exclusion list, and many other federal databases, as well as state-specific Medicaid and Medicare exclusion lists. </p>
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<p>Collect complete identifying information to ensure accurate database matching:</p>
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<p>Checkr also offers recurring healthcare sanctions checks to provide peace of mind. Since using Checkr, 95% of healthcare customers say they’ve experienced a simplified workflow; 86% say they’ve experienced faster turnaround and a better candidate experience.</p>
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<ul><li>Full legal name and known aliases</li>
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<p>Federal OIG background check requirements, as well as state laws and regulations, may vary depending on the specific healthcare employer. When performing healthcare background checks, employers should consult their legal counsel and be mindful of the following federal laws.</p>
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<li>Date of birth</li>
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<p><a>Section</a><a>1128</a>of the federal Social Security Act specifies reasons for mandatory or permissive exclusions and how long they last. Mandatory OIG exclusions last for five years. An individual or entity that receives two mandatory exclusions will be on the OIG LEIE for ten years; three exclusions place the offender on the list permanently. In general, permissive exclusions last three years or less.</p>
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<li>Social Security number (if permissible)</li>
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<p><a>Section 1156</a>of the Social Security Act defines the responsibilities of any healthcare provider receiving funding from federal healthcare programs; examples include providing only services that are medically necessary and meet professional standards.</p>
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<li>National Provider Identifier (NPI) and professional license numbers</li>
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<p>Although no law requires healthcare industry employers to check the OIG exclusion list, failing to do so may increase risk of legal liability, penalties, and fines. Following<a></a><a>OIG compliance guidance</a>for specific healthcare industry segments, including hospitals, nursing homes, and suppliers of durable medical equipment, can help your organization maintain OIG standards.</p>
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<li>Address history and previous employer information</li>
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<p>All employers who partner with a CRA must follow the federal<a></a><a>Fair Credit Reporting Act</a>(FCRA) when using information from a background check in their hiring processes. The FCRA requires employers to give candidates written notice that they plan to perform a background check and obtain their written permission to do so. If you intend to take negative action against a candidate or employee based on the results of a background check, including an OIG check, the FCRA requires that you follow the<a></a><a>adverse action process</a>.</p>
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</ul><p>Access the official databases:</p>
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<p>The<a></a><a>Equal Employment Opportunity Commission</a>(EEOC) enforces federal laws prohibiting discrimination in employment based on race, sex, color, religion, national origin, pregnancy, gender identity, sexual orientation, age, disability, and genetic information. If making hiring decisions based on the results of a criminal background check, the EEOC recommends considering the nature of the offense, when it took place, and its relevance to the job in question to mitigate potential discrimination against protected classes.</p>
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<ul><li><b>OIG LEIE database:</b>Available free at<a>exclusions.oig.hhs.gov</a></li>
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<p>Under the<a></a><a>Americans With Disabilities Act</a>(ADA), employers may not ask questions related to disabilities as part of a background check and cannot require a medical exam until a conditional offer of employment is made. Employers are also prohibited from discriminating against candidates who have a history of<a></a><a>substance abuse</a>, are currently in recovery, or are undergoing rehabilitation.</p>
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<li><b>SAM database:</b>Available free at<a>sam.gov</a></li>
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<h2>Join 100,000+ employers running faster background checks with Checkr</h2>
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</ul><p>Professional screening services can automate searches across multiple databases and provide ongoing monitoring capabilities.</p>
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<p>Not an employer? Run a background check on yourself<a>here ></a></p>
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<p>When the search returns potential matches:</p>
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<p>Let’s take a look at some of the most commonly asked questions about OIG background checks, the OIG exclusion list, and healthcare sanctions checks.</p>
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<ul><li>Compare identifiers (date of birth, Social Security number, NPI, license numbers)</li>
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<p>Healthcare industry employers may wish to run OIG background checks when hiring employees or contractors or vetting volunteers. Because the OIG exclusion list is updated regularly, the OIG also recommends conducting OIG checks of employees, contractors, and volunteers on a monthly basis. </p>
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<li>Request supporting documentation from the candidate if needed</li>
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<p>Employers should check the OIG exclusion list at least once per month for the most current results. The OIG exclusion list is updated monthly based on information provided by the states. Because a recently sanctioned individual or entity may not appear on the OIG exclusion list immediately, employers may also want to check state Medicaid exclusion lists when hiring. If you work with a background check partner, like Checkr, you may be able to automate monthly OIG list re-checks.</p>
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<li>Document the investigation process and final determination</li>
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<p>A person or entity typically gets added to the OIG exclusion list for Medicare, Medicaid, or other healthcare fraud, patient abuse, or neglect. Other reasons someone might appear on the OIG exclusion list may include:</p>
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<li>Remove confirmed matches from federally reimbursed duties immediately</li>
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<ul><ul><li><p>Felony convictions for healthcare-related financial misconduct</p>
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</ul><p>Maintain comprehensive records including:</p>
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</li>
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<ul><li>Individual or entity searched</li>
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<li><p>Felony or misdemeanor convictions for unlawfully manufacturing, prescribing, distributing, or dispensing controlled substances</p>
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<li>Identifiers used in the search</li>
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</li>
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<li>Databases checked and search dates</li>
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<li><p>Offenses related to delivery of Medicare services or items, or to services or items provided under Medicaid, SCHIP, or state healthcare programs</p>
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<li>Search results and any matches found</li>
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</li>
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<li>Resolution steps for potential matches</li>
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<li><p>Fraud in a non-healthcare program funded by a federal, state, or local government agency</p>
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</ul><p>Implement ongoing monitoring to catch new exclusions:</p>
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</li>
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<ul><li>Schedule monthly screening to align with LEIE updates</li>
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<li><p>A suspended, revoked, or surrendered license to provide healthcare</p>
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<li>Include SAM and relevant state lists in recurring searches</li>
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</li>
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<li>Use automated monitoring systems when possible for continuous coverage</li>
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<li><p>Submitting fraudulent claims to federal healthcare programs</p>
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</ul><p>Healthcare organizations can face serious consequences when they fail to screen candidates properly or ignore exclusion results.</p>
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</li>
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<p>Financial penalties can include:</p>
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<li><p>Participating in illegal kickbacks</p>
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<ul><li>Repayment of all claims associated with the excluded individual's services</li>
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</li>
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<li>Civil monetary penalties for each affected claim</li>
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<li><p>Defaulting on a health education loan or scholarship</p>
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<li>Additional assessments up to three times the amount claimed</li>
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</li>
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</ul><p>Regulatory consequences may include:</p>
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</ul><p>Being the owner, officer, or managing employee of a sanctioned entity</p>
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<ul><li>Suspension or revocation of program enrollment</li>
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</ul><p>The Office of Inspector General (OIG) is an independent entity that prevents fraud and mismanagement in US General Services Administration (GSA) operations and programs. Regarding OIG and GSA background checks, the OIG maintains the OIG exclusion list, while the GSA maintains the System for Award Management (SAM) database of federal contractors. Conducting both a SAM background check and an OIG check may be required and can help healthcare employers avoid hiring individuals or entities prohibited from receiving federal healthcare program funds.</p>
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<li>Loss of billing privileges with federal healthcare programs</li>
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<p><a>OIG background checks</a>can help healthcare employers maintain quality patient care and mitigate legal risk. However, checking the OIG exclusion list and other lists of individuals and entities with healthcare sanctions can be a highly manual process. You can simplify your healthcare sanctions and OIG background check process by partnering with Checkr.</p>
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<li>Mandatory corrective action plans and enhanced oversight</li>
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<p>Checkr offers multiple OIG background screening options for employers and candidates, including comprehensive searches of state and federal government databases. Checkr’s modern platform delivers fast, accurate OIG background check reports at any scale. Our ongoing OIG checks provide peace of mind, while our technology integrates seamlessly into your workflow. Save time and effort without sacrificing safety.<a></a><a>Get started</a>with Checkr.</p>
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</ul><p>Yes, you can search the OIG LEIE and SAM databases for free through their official government websites. However, many employers use professional screening services for automation, broader database coverage, and continuous monitoring capabilities.</p>
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<h2>Join 100,000+ employers running faster background checks with Checkr</h2>
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<p>Manual searches of government databases can be completed immediately if you have the necessary identifiers. Automated screening services typically return results within a few hours and can provide ongoing monitoring for new exclusions.</p>
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<p>Not an employer? Run a background check on yourself<a>here ></a></p>
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<p>Remove the individual from any federally reimbursed duties immediately and consult with legal or compliance counsel to assess disclosure requirements, potential repayment obligations, and other compliance steps. Document all actions taken and follow your organization's compliance policy for next steps.</p>
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<p>Checkr helps healthcare organizations maintain compliance through comprehensive exclusion screening. Our platform simplifies the complex process of OIG verification while providing the documentation and audit trails necessary for regulatory compliance.</p>
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<p>Checkr provides automated OIG exclusion screening that includes LEIE checks, SAM searches, and monthly monitoring. The platform integrates with HRIS, ATS, and healthcare systems to centralize documentation and maintain consistent compliance workflows.</p>
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<p>Organizations can streamline their healthcare sanctions screening process and reduce the administrative burden of manual database searches.<a>Get started with Checkr</a>to automate your OIG background screening program.</p>
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<h2>Start running business background checks</h2>
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<p>Order personal background checks<a>here ></a></p>
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<h4>About the author</h4>
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<h4>About the author</h4>
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<p>Karen Axelton writes about business topics and best practices. She has written hundreds of articles on business subjects, including background screening, hiring and employment trends, human resource management, and the use of technology in the workplace. Her work includes educational articles, e-books, white papers, and case studies.</p>
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<p>Karen Axelton writes about business topics and best practices. She has written hundreds of articles on business subjects, including background screening, hiring and employment trends, human resource management, and the use of technology in the workplace. Her work includes educational articles, e-books, white papers, and case studies.</p>