How to screen for OIG, SAM, and state Medicaid exclusions

Which exclusion lists must a healthcare provider screen?

A complete healthcare exclusion screen covers two federal lists and every applicable state Medicaid list. Fonteum combines all of them into a single “excluded-anywhere” signal, and adds a separate “compromised-anywhere” layer for federal monitoring short of exclusion.

How to screen a provider roster for exclusions

1. 1Assemble the roster you must screenList every employee, contractor, vendor, and ordering/referring provider. CMS expects screening of anyone who furnishes items or services payable by a federal health program — not just W-2 staff.
2. 2Screen the two federal listsCheck each name and NPI against the OIG LEIE (HHS healthcare-program exclusions) and SAM.gov (government-wide debarment). These are the baseline federal lists every program expects you to clear.
3. 3Screen every state Medicaid exclusion listAn individual excluded by one state's Medicaid program can relocate and practice elsewhere. Screening only the federal lists — or only your own state — leaves that gap open. Fonteum mirrors 17 state Medicaid exclusion lists so a roster clears every jurisdiction Fonteum currently holds in one pass.
4. 4Resolve matches by NPI, then confirm at the sourceMatch on NPI where present and on name where it is not, then confirm every hit against the primary list before any adverse action. A false match flags a clean provider; a missed match clears an excluded one — identity resolution is the whole game.
5. 5Document the screen and repeat monthlyKeep a dated record showing which list you checked, on what date, and the matched record. The OIG updates the LEIE monthly and recommends monthly screening, so the documentation has to be re-generated on that cadence.

How to check a specific state's Medicaid exclusions

Each guide names the state's Medicaid integrity authority, links the primary list, and shows how it fits an “excluded-anywhere” screen.

• Check Colorado Medicaid exclusions →Colorado Department of Health Care Policy & Financing (HCPF)
• Check Georgia Medicaid exclusions →Georgia DCH Office of Inspector General
• Check Indiana Medicaid exclusions →Indiana FSSA, Office of Medicaid Policy and Planning (OMPP)
• Check Iowa Medicaid exclusions →Iowa Health and Human Services (Iowa Medicaid)
• Check Kansas Medicaid exclusions →Kansas Department of Health and Environment, Division of Health Care Finance (KDHE-DHCF)
• Check Kentucky Medicaid exclusions →Kentucky CHFS, Department for Medicaid Services (DMS)
• Check Maryland Medicaid exclusions →Maryland Department of Health (MDH)
• Check Mississippi Medicaid exclusions →Mississippi Division of Medicaid (DOM)
• Check Montana Medicaid exclusions →Montana Department of Public Health and Human Services (DPHHS)
• Check New Hampshire Medicaid exclusions →New Hampshire Department of Health and Human Services (DHHS)
• Check New York Medicaid exclusions →NY Office of the Medicaid Inspector General (OMIG)
• Check North Carolina Medicaid exclusions →NC DHHS, Division of Health Benefits (NC Medicaid)
• Check North Dakota Medicaid exclusions →North Dakota Health and Human Services (HHS), Medicaid Program Integrity
• Check Ohio Medicaid exclusions →Ohio Department of Medicaid (ODM)
• Check Pennsylvania Medicaid exclusions →Pennsylvania Department of Human Services (DHS)
• Check Tennessee Medicaid exclusions →Tennessee TennCare, Office of Program Integrity
• Check Washington Medicaid exclusions →Washington State Health Care Authority (HCA)

Common questions

How do I screen for OIG exclusions for free?

Search the OIG LEIE directly, or use Fonteum's free OIG exclusion search by name or NPI. For an entire roster, Fonteum offers a free same-day full-roster screen across the OIG LEIE, SAM.gov, and every state Medicaid exclusion list it mirrors, returning a signed attestation PDF. The OIG LEIE is a federal public work, so the data itself is free to download and cite at /sanctions.

How often must healthcare providers screen for exclusions?

The OIG recommends screening all employees and contractors against the LEIE monthly, because the list is republished monthly and the civil monetary penalty for employing an excluded person accrues per item or service. Many state Medicaid programs impose their own monthly screening expectation. A monthly cadence, documented against the dated federal and state files, is the defensible standard.

What is the difference between the OIG LEIE and SAM.gov?

The OIG LEIE (List of Excluded Individuals and Entities) is the HHS Office of Inspector General's list of parties excluded from federal healthcare programs under sections 1128 and 1156 of the Social Security Act. SAM.gov holds government-wide debarments across all federal agencies and procurement. They overlap but are distinct: a healthcare compliance screen needs both, plus the relevant state Medicaid exclusion lists.

Do I need to screen state Medicaid exclusion lists too?

Yes. Most state Medicaid programs publish their own exclusion or termination lists, and a provider excluded by one state may not appear on the federal LEIE. CMS guidance and many state contracts require screening the applicable state lists. Fonteum mirrors 17 state Medicaid exclusion lists alongside the OIG LEIE and SAM.gov, combined into one “excluded-anywhere” screen so a single-state exclusion on a relocated provider still surfaces.

What does it cost to employ an excluded provider?

Under Section 1128A of the Social Security Act, the OIG can impose civil monetary penalties of up to $24,947 per item or service furnished by an excluded individual, plus treble damages, and the organization may have to repay the federal program (see OIG guidance on the effect of exclusion). The penalty accrues per claim, so a single excluded employee can generate substantial exposure between screening cycles — which is why monthly screening is the recommended cadence.

What does Fonteum's free roster screen include?

Upload a provider roster and Fonteum screens every name and NPI against the OIG LEIE, SAM.gov, and all 17 state Medicaid exclusion lists it mirrors, plus OIG Corporate Integrity Agreement and CMS civil-money-penalty flags. It returns an Ed25519-signed, hash-chained attestation PDF in which every match traces to its federal or state source file, snapshot date, and methodology version. Public data only — no PHI, and no sales demo to get the first screen. Start at pilot intake.

Screen your whole roster against every list — free.

Upload your provider roster and get a free same-day full-roster screen across OIG-LEIE + SAM + all 17 state Medicaid lists, plus a signed attestation PDF. No PHI, no demo. The pilot is published at $2,500–$5,000/mo with a 30-day no-penalty exit.

• /data/state-exclusions → The federal + state “excluded anywhere” data hub.
• /sanctions → Public OIG LEIE aggregate surface, free to browse and cite.
• /tools/oig-exclusion-search → Search the OIG LEIE by name or NPI.
• /compare/exclusion-screening-vs-single-list-checks → Why a multi-list screen beats checking one list.
• /compare/providertrust-alternative → Compare Fonteum to a continuous-monitoring incumbent.