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What Is the OIG Exclusion List?

What the HHS-OIG List of Excluded Individuals/Entities actually prohibits, the difference between mandatory and permissive exclusion, and how reinstatement works.

Reviewed

The List of Excluded Individuals/Entities (LEIE) is a federal database maintained by the Office of Inspector General of the U.S. Department of Health and Human Services (HHS-OIG). It names every individual and entity currently barred from participating in federally funded health care programs, under authority granted by section 1128 of the Social Security Act and, for a narrower category of quality-of-care exclusions, section 1156.

What exclusion actually prohibits

An excluded individual or entity can receive no payment from any Federal health care program for any item or service they furnish, order, or prescribe — not just Medicare and Medicaid claims billed directly under their own name. The prohibition reaches items and services paid for indirectly through federal funds as well, with one narrow carve-out for the Federal Employees Health Benefits Program. An organization that knowingly employs or contracts with someone on the list can face civil monetary penalties even if the excluded person never personally bills a program.

Mandatory vs. permissive exclusion

Mandatory exclusionPermissive exclusion
AuthoritySocial Security Act §1128(a)(1)–(a)(4)Social Security Act §1128(b)(1)–(b)(16) and §1156
Is OIG required to exclude?YesNo — it is discretionary
Typical groundsConviction of Medicare/Medicaid fraud, patient abuse or neglect, a health-care-related felony, or a felony controlled-substance offenseMost commonly a state license revocation or suspension; also misdemeanor fraud, kickbacks, and substandard care, among other grounds
Minimum period5 years (10 years for a second mandatory exclusion; permanent for a third)Varies by the specific ground for exclusion

State licensing-board actions account for the large majority of permissive exclusions in practice, which is one reason the LEIE and a state license lookup often move in tandem — a physician who loses their license for cause is frequently excluded from federal programs on that same basis, though the two databases remain legally and operationally separate.

Reinstatement is not automatic

Reaching the end of an exclusion period does not restore eligibility by itself. HHS-OIG requires the excluded individual or entity to submit a written reinstatement request — including their name, and for individuals their date of birth, along with contact information — and to receive written notice from OIG that reinstatement has been granted before they may participate in Medicare, Medicaid, or any other federal health care program again. For a defined exclusion period, that request can be submitted starting 90 days before the period ends, but not earlier. Separately obtaining a Medicare or state provider number does not itself reinstate anyone; only OIG's written approval does.

How the list is kept current

OIG republishes the full LEIE monthly and posts a supplemental file between full releases for anyone maintaining their own copy of the data, in addition to a free online search tool. NPISignal imports the full monthly file; see Data Sources for the exact publication date NPISignal currently has loaded.

How NPISignal matches the LEIE to an NPI

Exact NPI only, never a name match

NPISignal only ever surfaces an exact match on the NPI number itself between a provider record and an LEIE entry. It never shows a name-based match as an exclusion finding, because a name match alone is not an identification — two different people can share a name, and the LEIE's own NPI field is often blank for older entries. Even an exact NPI match on the current data does not eliminate the possibility of a data or identity error; it means an active LEIE record naming that NPI existed in the dataset NPISignal most recently imported.

The full mechanics — what counts as a match, what NPISignal displays either way, and its limitations — are documented on the Methodology page.

  • Search the LEIE directly, independent of NPISignal, at OIG's own site — see the source link below.
  • Remember that the LEIE and an active NPI are answers to two different questions: an active NPI says a number was issued and never deactivated; the LEIE says whether that same NPI currently appears on the exclusion list. A provider can be enumerated and excluded at the same time.

Exclusions Database — search the LEIE directly — HHS Office of Inspector General

Sources

  1. Background Information & Exclusion Authorities (Social Security Act §§1128, 1156; mandatory vs. permissive) — HHS Office of Inspector General. Accessed August 20, 2026.
  2. About Reinstatement (written request requirement, 90-day window, OIG approval required) — HHS Office of Inspector General. Accessed August 20, 2026.
  3. Exclusions Program overview (effect of exclusion, FEHBP carve-out) — HHS Office of Inspector General. Accessed August 20, 2026.
  4. Exclusions Database — LEIE online search and downloadable files — HHS Office of Inspector General. Accessed August 20, 2026.