Exclusion screening is the process of verifying that individuals, vendors, and contractors are not barred from participating in government-funded healthcare programs such as Medicare and Medicaid. The screening ensures compliance with federal and state laws and prevents billing or contracting violations.

Federal law mandates exclusion screening to prevent fraud, waste, and abuse in publicly funded programs. Hiring or contracting with an excluded party can lead to civil monetary penalties (CMPs) and even loss of eligibility to participate in Medicare or Medicaid programs.

Two key federal databases form the foundation of screening:

• OIG LEIE (List of Excluded Individuals and Entities): Managed by the U.S. Office of Inspector General (OIG).
• GSA SAM (System for Award Management – Exclusions): A comprehensive federal exclusion database that consolidates multiple legacy systems such as EPLS and CCR.

Industry best practice—and in many cases, state guidance—calls for screening at least monthly for all employees, contractors, and vendors. Screening should also be performed at the time of hire or engagement.

Most states maintain their own exclusion or debarment lists in addition to federal lists. However, a few states—such as New Mexico, Oklahoma, Rhode Island, South Dakota, Utah, Virginia, and Wisconsin—rely solely on the OIG LEIE for reporting exclusions.

Organizations may face civil monetary penalties, potential exclusion from federal programs, and reputational harm. For example, Baptist Health Deaconess Madisonville was fined over $21,000 for employing an excluded individual.

You can perform screening by:

• Searching manually using the OIG's LEIE database at exclusions.oig.hhs.gov.
• Searching the GSA SAM database at sam.gov.
• Using automated compliance platforms such as SecureEPLS or GarlandLive, which offer batch screening, reporting, and outsourcing options.

The LEIE focuses specifically on healthcare-related exclusions under the OIG's authority, while SAM includes a broader range of federal exclusions—including procurement and non-procurement programs—making it more comprehensive.

Regulations such as 42 CFR §424.516 require Medicare-certified providers to ensure that they do not employ or contract with excluded or debarred individuals or entities. Non-compliance can result in fines, sanctions, or exclusion from federal programs.

Even if you don't participate in government programs, screening helps ensure your workforce is free from individuals with histories of fraud or abuse, supporting safety, quality of care, and organizational integrity.