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Professional OIG Exclusion List Monitoring

Effective Risk Management for the Health Care Community

Exclusion List Monitoring

All health care entities that participate in state and federally funded programs, such as Medicare and Medicaid, are prohibited from employing or conducting business with individuals and companies that have been placed on exclusion lists. The Office of Inspector General requires facilities receiving funding to cross-reference their employees, vendors, and contractors against a list of parties excluded from participating in state and federal health care programs both at the time of hire/contract and at least every thirty days thereafter. Submitting claims for reimbursement in which an excluded party contributed to the delivery of medical items or services can expose your facility to unnecessary liability, including, but not limited to:

  • Fines of up to $10,000 for each item or service claimed
  • Treble damages of up to three times the amount claimed
  • Possible exclusion from federal and state health programs

Given these substantial consequences, compliance is essential to the health and sustainability of your business.

What We Offer

As you well know, these exclusion check requirements can be quite time consuming and, if not done properly, can expose your facility to unnecessary risk and liability. Don’t entrust your exclusion checks to an employee who may or may not have time to carefully and regularly protect your business. Since the effects of an oversight can negatively impact your entire operation, it is critical that it’s done consistently and correctly. Let us handle it for you. Backed by more than twenty years of investigative and risk management experience, Whelan & Whelan is a leading provider of risk identification and mitigation solutions. Our professional and affordable services can help you with all your screening and risk assessment needs. From background checks to workplace investigations our investigative experience allows us to go beyond other exclusion list monitoring companies to provide you with peace of mind.

How It Works

We will perform a monthly search of the OIG’s List of Excluded Individuals and Entities (LEIE), the System for Award Management (SAM), and relevant state maintained Medicaid exclusion lists for each of your facilities. Simply provide us with a spreadsheet outlining your current employees, vendors, and referral sources and we will use this information to accurately search each database on your behalf. You will receive a detailed monthly report containing the results of each name search and be immediately alerted when we have a positive, verified name match. It’s that simple.

Special Added Bonus for Annual Plan Subscribers: Receive Free Professional License Verification and Disciplinary Checks for Your Employees and Referral Sources

By utilizing this service, you can be confident that you are receiving accurate and professional results with each search. Can you guarantee that the person or firm performing your exclusion list checks is doing so as accurately and comprehensively as we do? We maximize compliance by using research industry standard best practices, such as:

  • Using initial and common short form of first names
  • Common misspellings of first and last names
  • Search all current and prior names associated with individual (e.g., married and maiden names)

Our investigative background allows us to utilize industry best practice standards to isolate and utilize all relevant information discovered in your employee and vendor background investigations to ensure that searches are being performed with the most accurate and up to date personal identifiable information.


Key Features

  • Consistently Meet Compliance Standards
  • Professional Risk Management
  • Accurate Results
  • Reliable Monitoring
  • Timely Notification
  • Low Monthly, Quarterly, and Annual Plans

Find Out More

What is OIG Exclusion List Monitoring?

Find the answer to this and other questions in our FAQ’s.

Get Answers Here

Recent & Notable OIG Settlements
Norwalk Hospital Association (CT)
September 2, 2014 - Agreed to pay $330,967.29 for allegedly employing an individual that it knew or should have known was excluded from participation in Federal health care programs.
Rescue, Inc. (VT)
September 9, 2014 - Agreed to pay $152,593 for allegedly employing an individual that it knew or should have known was excluded from participation in Federal health care programs.
University of California, Los Angeles (CA)
September 19, 2014 - Agreed to pay $470,422.85 for allegedly employing an individual that it knew or should have known was excluded from participation in Federal health care programs.
Reliable Respiratory, Inc. (MA)
October 1, 2014 - Agreed to pay $23,065.89 for allegedly employing an individual that it knew or should have known was excluded from participation in Federal health care programs.
The County of Wilson Emergency Medical Services (NC)
October 16, 2014 - Agreed to pay $124,688.54 for allegedly employing an individual that it knew or should have known was excluded from participation in Federal health care programs.
ManorCare Health Services (UT)
October 16, 2014 - Agreed to pay a $41,129.76 settlement to resolve allegations that it employed an individual who was excluded from participating in any Federal health care programs.
Daybreak Venture, LLC (TX)
October 24, 2014 - Agreed to pay a $357,341.96 settlement to resolve allegations that seven facilities operated by Daybreak each employed an individual who was excluded from participating in any Federal health care programs. These facilities then billed Federal health care programs for items or services provided by the excluded individuals.
Mid-Atlantic of Delmar, LLC (DE)
October 20, 2014 - Agreed to pay $92,344.60 for allegedly employing an individual that it knew or should have known was excluded from participation in Federal health care programs.

Report Fraud at oig.hhs.gov 

Common Issues Faced By Facilities Leading to Unnecessary Risk and Liability


Leaving OIG Exclusion Checks to Employees With Other Demanding Responsibilities


A Lack of Attention to Detail When Searching (Not Searching Name Variations or First Initials)


Not Exhausting a Search of Every Available Exclusion List Every Month


Failing to Check Each Employee, Vendor, or Referral Source Against Each List


Failing to Check the Medicaid Exclusion Lists in Every State or Those Connected With An Employee


Not Ensuring the Required Checks Are Being Performed For Each Employee/Vendor Consistently Every Month

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