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

Screen your roster against the currently loaded lists — right now

Paste your provider NPIs and see matches from OIG LEIE, SAM.gov, and the currently loaded state Medicaid lists. Up to 25 unique ten-digit NPI inputs are screened. The result stays on screen: no download, email delivery, or monitoring. No PHI; the roster is not stored.

Which exclusion lists must a healthcare provider screen?

A complete healthcare exclusion screen covers two federal lists and every applicable state Medicaid list. Fonteum currently combines the two federal lists with the loaded state lists (GA, IA, MD, MS, MT, NC, ND, NH, NY, OH, PA, TN, WA) into a single “excluded-anywhere” signal, and adds a separate “compromised-anywhere” layer for NPI-linked federal integrity records short of exclusion. It does not claim coverage of the other states.

How to screen a provider roster for exclusions

1. 1Assemble the roster you must screenList every provider, contractor, vendor, and ordering/referring party you bill federal programs for. CMS expects you to check anyone who furnishes items or services payable by a federal health program — not just the parties on your own payroll.
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 check.
3. 3Screen every applicable 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 the currently loaded state Medicaid exclusion lists (GA, IA, MD, MS, MT, NC, ND, NH, NY, OH, PA, TN, WA) in one pass. Fonteum does not claim coverage of the other states. Any loaded source whose serving coverage is stale or cannot be matched to an attested artifact returns indeterminate.
4. 4Resolve matches by NPI, then confirm at the sourceFonteum's on-demand product accepts ten-digit NPIs, not name-only rows. Confirm every consequential match against the primary list before any adverse action; a false match can flag the wrong provider, and a missed match can hide an excluded one.
5. 5Document the screen and set a recurring cadenceKeep a dated record showing which list you checked, on what date, and the matched record. OIG updates the LEIE monthly and says monthly screening best minimizes potential overpayment and civil-monetary-penalty exposure; applicable state and program rules can differ.

How to check a specific state's Medicaid exclusions

Each guide names the state's Medicaid integrity authority and links the primary list. The product screen currently loads state lists for GA, IA, MD, MS, MT, NC, ND, NH, NY, OH, PA, TN, WA; a guide does not imply that its state is already loaded.

• 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 Louisiana Medicaid exclusions →Louisiana Department of Health (LDH), Program Integrity
• Check Maryland Medicaid exclusions →Maryland Department of Health (MDH)
• Check Massachusetts Medicaid exclusions →Massachusetts MassHealth (EOHHS), Office of Program Integrity
• Check Michigan Medicaid exclusions →Michigan Department of Health and Human Services (MDHHS), Medicaid Program Integrity
• Check Mississippi Medicaid exclusions →Mississippi Division of Medicaid (DOM)
• Check Missouri Medicaid exclusions →Missouri Medicaid Audit and Compliance (MMAC), Department of Social Services
• 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 South Carolina Medicaid exclusions →South Carolina Department of Health and Human Services (SCDHHS), Program Integrity
• 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. Fonteum's on-demand roster screen accepts up to 25 unique ten-digit NPI inputs and shows counts plus a matched-source breakdown on screen only. It checks OIG LEIE, SAM.gov, and the currently loaded state Medicaid exclusion lists (GA, IA, MD, MS, MT, NC, ND, NH, NY, OH, PA, TN, WA); it does not create a free report, send email, or enroll monitoring.

How often does OIG recommend exclusion screening?

OIG says providers are not generally required by statute or regulation to check the LEIE, but recommends checking before employing or contracting and periodically afterward. Because OIG updates the LEIE monthly, it says monthly screening best minimizes potential overpayment and civil-monetary-penalty exposure. Applicable state, contract, and program rules can impose their own cadence.

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 the currently loaded state Medicaid exclusion lists (GA, IA, MD, MS, MT, NC, ND, NH, NY, OH, PA, TN, WA) alongside the OIG LEIE and SAM.gov. Fonteum does not cover the other states.

What does it cost to bill for an excluded provider?

Under Section 1128A of the Social Security Act, civil monetary penalties, additional assessments, and repayment can apply when federal programs are billed for items or services furnished by an excluded party (see OIG guidance on the effect of exclusion). The applicable amounts are adjusted over time; consult the current statute, regulations, and OIG guidance rather than relying on a static dollar figure.

What does Fonteum's free roster screen include?

The current roster screen accepts up to 25 unique ten-digit NPI inputs, not arbitrary name-only rows. It checks supported NPI-keyed records against the OIG LEIE, SAM.gov, and the state Medicaid exclusion lists currently loaded (GA, IA, MD, MS, MT, NC, ND, NH, NY, OH, PA, TN, WA), plus OIG Corporate Integrity Agreements and CMS civil-money-penalty records, when an NPI-linked record is available. Other states are not covered. Results show counts and a matched-source breakdown on screen only; no free artifact, email, or monitoring is created. A negative may be indeterminate when source coverage is stale or incomplete. Public data only — no PHI.

Screen your roster against the currently loaded lists — free.

Paste up to 25 unique ten-digit NPIs and see counts plus a matched-source breakdown from OIG LEIE, SAM.gov, and the currently loaded state Medicaid lists. The free workflow is on-screen only and may return indeterminate when coverage is stale or incomplete.

• Free screen (providers + contractors) → Screen a healthcare roster or a federal contractor against the currently loaded lists in one place.
• Exclusion & sanctions screening guide → The topical hub linking the data, studies, and federal-contracting side.
• How often to check the OIG exclusion list → The OIG-stated monthly cadence and the monthly LEIE file-replacement mechanics, with dated sources.
• /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.