List of Excluded Individuals and Entities (LEIE)

 Health care professionals and businesses need to take care of an advanced set of federal and state laws and regulations also as profoundly negative consequences because of failure to suits these laws. One of these consequences is the HHS OIG

List of Excluded Individuals and Entities (LEIE).

 The OIG Exclusion Search consists of people and entities who are excluded from participating in federal healthcare programs. Under Sections 1128 and 1156 of the Social Security Act provide authority to the OIG Search to exclude individuals and entities from federal health care programs like Medicare and Medicaid. Individuals may be excluded for reasons that fall under one among two categories: permissive or mandatory. However, exclusions are applied broadly in both categories.

1.       Mandatory exclusions require the OIG, by law, to exclude from participation in all Federal health care programs. Examples of infractions considered for mandatory exclusion: conviction of healthcare program-related crimes, conviction relating to patient abuse, felony conviction relating to health care fraud, or felony conviction relating to a controlled substance.

2.       Permissive exclusions are discretionary. Although not required by law, OIG Exclusion Search may exclude individuals and entities for reasons such as misdemeanor convictions related crimes health care fraud, misdemeanor convictions relating to the unlawful manufacture, distribution, prescription, or dispensing of controlled substances, and submission of false or fraudulent claims to a Federal health care program among others.

3.       OIG Exclusion Search- HHS prepares and maintains LEIE for the precise purpose of identifying persons or entities that are excluded from the Medicare Program by its Inspector General. The database is updated monthly. The LEIE is often accessed on the OIG’s website and up to five names can be searched at a time. OIG Search also can be downloaded for searching purposes. Matches can then be verified individually by

4.       Social Security Number. -If you’re checking out quite a few individuals or entities, it’s best to download the entire LEIE file and use the CSV file or a database program to perform the searches. There are also automated OIG exclusions monitoring services that will cross-reference your employee roster with the LEIE every month,automatically. These services will then alert administrators if there’s a match so they can investigate further.