Exclusion Checks

U.S. Department of Health and Human Services – Office of the Inspector General (HHS-OIG), and the U.S. General Services Administration (GSA), and State Exclusion Checks

Regulators prohibit our organization from hiring, employing or making payments to any person or business excluded or debarred from federal or state health care programs.

PDF Exclusion Checks Instructions

Frequency

Delegates must review all employees and subcontractors that support Medicare Advantage Parts C & D and/or Medicaid plans and membership against OIG and GSA federal exclusion lists prior to hiring or contracting and on a monthly basis thereafter.


Medicare & Medicaid

All delegates working with our Medicare Advantage Parts C and D or Medicaid programs must review the federal exclusion lists maintained by the U.S. Department of Health and Human Services – Office of the Inspector General (HHS-OIG) and the U.S. General Services Administration (GSA). These exclusion lists name individuals or organizations that are suspended or otherwise excluded from participation in Medicare and Medicaid programs.


Federal Exclusion Checks

Health and Human Services-Office of Inspector General List of Excluded Individuals and Entities (LEIE)

Learn more
 OIG Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs

OIG Exclusions Background Information 

General Services Admission (GSA) System for Award Management (SAM)


State Exclusion Checks

Many states maintain state-based sanction/exclusion databases that are in addition to, but do not replace, the OIG and GSA federal exclusion databases. A provider may not participate in the network of a specific state if the provider is listed on that state’s exclusion list, even if the provider is not listed on a federal exclusion list.

State exclusion list resource

Verify Comply® is a vendor that offers several exclusion list search options.

 Verify Comply Federal & State Exclusion Lists

UnitedHealth Group and its businesses are not affiliated with the above independent websites.