What Is the OIG Exclusion List? A Plain-English Guide

If you run a home health agency, you've heard the term "OIG exclusion list" thrown around during surveys, in compliance training, and probably in a few anxious emails from your billing department. But what is it, exactly? And why should you care?

This guide breaks it down in plain language—no legalese, no fluff.

What the OIG Exclusion List Actually Is

The Office of Inspector General (OIG) maintains a database called the List of Excluded Individuals and Entities, or LEIE. It contains the names of every person and organization that has been barred from participating in federal healthcare programs—Medicare, Medicaid, CHIP, and all other programs funded by the federal government. (If you are wondering how this compares to SAM.gov, see our guide on LEIE vs. SAM.gov.)

When someone is on this list, no federal healthcare dollar can flow to them. Not for services they provide, not for items they supply, not for prescriptions they write. The exclusion is absolute.

As of early 2026, the LEIE contains roughly 78,000 active exclusion records. OIG updates the list monthly, adding new exclusions and removing individuals whose exclusion periods have ended.

Who Gets Excluded and Why

Exclusions fall into two categories defined by the Social Security Act:

Mandatory Exclusions (Section 1128(a))

OIG is required to exclude individuals convicted of:

• Medicare or Medicaid fraud
• Patient abuse or neglect in connection with healthcare delivery
• Felony convictions related to healthcare fraud
• Felony convictions related to controlled substances

These carry minimum five-year exclusion periods. Many are longer.

Permissive Exclusions (Section 1128(b))

OIG may exclude individuals for a broader set of reasons, including:

• Misdemeanor convictions related to healthcare fraud
• License revocation or suspension
• Defaulting on health education loan repayments
• Submitting false claims
• Kickback violations

Permissive exclusions have a minimum three-year period, but the OIG has wide discretion.

The Penalties for Employing Excluded Individuals

Here is where it gets serious. If your agency employs or contracts with someone on the LEIE—even if you didn't know they were excluded—you are liable. The Civil Monetary Penalties Law (CMPL) allows OIG to impose:

• Up to $100,000 per arrangement with an excluded individual
• Up to $10,000 per item or service furnished by the excluded individual (adjusted for inflation—currently $22,427 per item/service as of the 2024 Federal Register inflation adjustment)
• Treble damages—three times the amount claimed for each item or service
• Exclusion of your entire organization from federal healthcare programs

That last one is the death sentence. If your agency gets excluded, you cannot bill Medicare or Medicaid at all. For most home health agencies, that is the end of the business.

The "I Didn't Know" Defense Doesn't Work

OIG has made it clear: ignorance is not a defense. The obligation to screen is on the provider. If you hired a nurse who was excluded three years ago and you never checked, you are still on the hook for every service they provided during their employment.

This is strict liability. It does not matter that the employee lied on their application. It does not matter that they had a valid state license. The exclusion is a federal matter, and state licensing boards do not always cross-reference the LEIE.

How Often Should You Screen?

OIG's own guidance recommends checking the LEIE monthly (see our full guide: How Often Should You Screen Staff Against the LEIE?). The list is updated on or around the 20th of each month. Best practice is to screen:

• Before hiring (pre-employment screening)
• Monthly for all current employees and contractors
• Before contracting with any new vendor or supplier

For a complete compliance checklist that covers OIG screening alongside eligibility verification, HIPAA reviews, and survey readiness, see our Home Health Compliance Checklist for 2026.

Many agencies still screen only at hire and then annually. That leaves up to 11 months of exposure. If someone gets excluded after you hire them, annual screening means you could be billing federal programs for their services for nearly a year before you catch it.

The Manual Screening Problem

Checking the LEIE manually means going to the OIG website, entering each employee's name one at a time, and reviewing the results. For an agency with 50 staff members, that is 50 individual searches every month. For an agency with 200, it is 200.

But the bigger problem is accuracy. The LEIE search requires exact name matches. If your employee's legal name is "Maria Gonzalez-Reyes" and she was excluded under "Maria Gonzalez," a manual search might miss her. Name variations, maiden names, hyphenated names, and accented characters all create gaps.

How ClientCare Automates OIG Screening

ClientCare screens your entire staff roster against both the OIG LEIE and SAM.gov every month, automatically. No manual lookups. No spreadsheets.

Our screening engine uses fuzzy name matching that handles the exact problems manual screening misses—name variations, accented characters, suffixes like Jr. and III, and transposed names. When we find a potential match, we flag it as a risk ticket on your dashboard with a confidence score so you can investigate immediately.

You upload your roster once. We handle the rest.