How often should a healthcare employer screen for OIG exclusions?

Published 2026-09-15. Sources are linked where each rule is quoted.

The question comes up in every survey prep and every new-hire packet: how often do we have to check our people against the exclusion lists? The federal answer lives in one document, and most state answers point back to it. This article quotes what the documents say and links them, so you can read the rule yourself rather than take a vendor's word for it.

What the OIG bulletin says

In May 2013 HHS-OIG published its Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs. It replaced a 1999 bulletin and remains OIG's standing statement on the subject. On frequency, the bulletin recommends that providers check the LEIE before hiring or contracting with a person and then periodically, and it notes that because OIG updates the LEIE monthly, screening employees and contractors each month best minimizes potential overpayment and civil monetary penalty liability.

Two things follow from that paragraph. Monthly is a recommendation about how to limit liability, not a statutory deadline in itself, and it is a recommendation because the list itself changes monthly: a person hired in March and never rechecked could be excluded in April and stay on the payroll for years while every claim they touch is unpayable. The bulletin also reminds providers that the payment prohibition reaches administrative and management staff, not only clinicians who bill.

Where the monthly cadence became a state rule

In January 2009 CMS sent letter SMD 09-001 to the states' Medicaid directors, which advised each state's Medicaid agency to require its enrolled providers to search the LEIE monthly for excluded employees and contractors. Many states wrote that into provider agreements, manuals or regulations, and several added their own state exclusion or termination lists to the check.

New York is the clearest example: the Office of the Medicaid Inspector General publishes its own exclusion list and directs Medicaid providers to check both it and the federal list when hiring and on an ongoing basis. Other states publish similar direction in their provider manuals. Which rule applies to your organization depends on the programs you bill and the states you operate in; the agency pages linked from our source pages are the place to read them.

Why annual screening leaves a gap

Exclusions take effect on a specific date and the lists are refreshed on a schedule: the LEIE monthly, SAM.gov daily, most state lists monthly or as actions occur. An annual check therefore leaves up to eleven months in which a newly excluded employee is invisible to you but visible to any auditor who pulls the list. The 2013 bulletin's reasoning about monthly screening is exactly this arithmetic.

The other half of frequency is proof. A check that was performed but not documented is hard to distinguish, months later, from one that was never performed. Whatever cadence you adopt, the record of each check (what was searched, when, against which version of the list, and what was done about any hit) is what a surveyor reads.

A note on what a check produces

Any name search against these lists produces potential matches, not determinations. Common names collide, and most lists publish no date of birth. The 2013 bulletin itself describes verifying a possible match against identifying information before acting. A screening record that shows each potential match and how it was resolved is worth more than one that shows only a count of zero.