If your practice bills Medicaid or Denti-Cal, federal law holds you responsible for screening every employee and vendor against the exclusion lists — every month — and proving you did. We run that screen and hand you the dated record. You stay protected.
Most practice owners have never read the statute — and that is exactly the exposure. The obligation to screen does not come from a vendor trying to sell you something. It comes from the Social Security Act and the Code of Federal Regulations, and it has been enforced against practices of every size, including solo physicians and small clinics, for years.
The core rule is simple and unforgiving: no federal health care program will pay for anything furnished, ordered, or prescribed by an excluded person. The moment an excluded individual touches a claim — as a hygienist, a nurse, a biller, a contractor, even a back-office administrator whose work feeds a billable service — every one of those claims becomes a violation. Not a warning. A violation, priced per item.
"OIG's LEIE must be checked on a monthly basis… To avoid CMP liability, health care entities should routinely check the list to ensure that new hires and current employees are not on it."
— HHS Office of Inspector General, Exclusions Program · oig.hhs.gov/exclusionsThere is no version of this where you opt out of the liability. You are responsible the day an excluded person touches a claim — whether the hire was deliberate or an honest oversight. The OIG's enforcement standard is "knew or should have known," and because the LEIE is public and free, the law expects you to have checked — so a good-faith "we didn't realize" unfortunately doesn't lift the liability. That is precisely why a simple, documented monthly screen matters.
It is rarely an investigator at your front door. The exposure surfaces three quiet ways:
1. Automated claims-matching. The OIG and CMS contractors cross-reference submitted claims data against the LEIE by computer. An excluded name on your claims can surface without anyone visiting your office.
2. Routine audits. During a payer or program audit, you are asked to produce your screening records. No dated proof of monthly screening is itself the finding.
3. Whistleblowers. A former employee or competitor reports you — and under the False Claims Act, they share in the recovery, which is why these reports happen.
Sources: HHS-OIG Exclusions Program; OIG Updated Special Advisory Bulletin on the Effect of Exclusion; 42 CFR Parts 1001 & 1003. All linked above resolve to oig.hhs.gov and ecfr.gov.
Every settlement below is a real, public OIG enforcement action for employing an excluded individual. Not hospitals only — solo physicians, small clinics, pharmacies, addiction and home-care providers. You can verify each on the government's own enforcement pages.
A simple list of staff, contractors, and vendors — names, plus NPI if you have it. No SSNs, no patient data, ever.
Against the federal exclusion and sanction lists — OIG LEIE, GSA/SAM, and OFAC — and flag the few that need a closer look.
A clean PDF showing who is clear and who to verify — the dated, attributed record an auditor asks for. Every month, on file.
We tell you exactly which few names to confirm at the official source before any action — so you act on certainty, not a name collision.
The large compliance firms were built for hospitals and health systems: per-provider contracts, annual lock-ins, and a sales team that won't return a small practice's call. We were built for the practices they ignore.
Want to see the actual report first? Request a sample. When you're ready, choose your level.
Base covers the federal obligation every billing practice shares. Most owners start here — it's the check the OIG expects and the dated record an auditor asks for first.
Plus exists because federal isn't the whole picture. If you bill a state Medicaid program, that state very likely maintains its own exclusion list, separate from the federal LEIE — and screening the federal list does not satisfy the state one. Practices tend to move to Plus when any of these become true:
Your roster stays private. We only receive staff or vendor data after you're a client, under a short written agreement that spells out how it's handled — and we don't retain it if you leave. A sample report uses example data, so you can see exactly what you'll get without sending us anything confidential.
Not sure which fits today? Start on Base — you can move up the moment your exposure changes, and we'll confirm exactly what your state requires before you pay a cent more. Or request a sample report to see the deliverable first.
Tell us a little about your practice and we'll send you a sample report — the real format, the real flags, the exact documentation you'd receive each month. No roster required to see it. When it fits, you subscribe, and the screening begins.
Request a Sample Report