Exclusion FAQS

Quick OIG Exclusion Basics
Which government agency handles OIG Exclusions?
The Office of Inspector General (OIG) handles OIG Exclusions. It is a part of the U.S. Department of Health and Human Services (HHS). The HHS-OIG is responsible for combating federal healthcare fraud, waste and abuse through OIG Exclusions.
What is an OIG Exclusion?
Those guilty of fraud, waste and abuse are excluded from participating in federal healthcare programs and placed on the LEIE by the HHS-OIG.
What is LEIE?
The LEIE stands for the List of Excluded Individuals/Entities. Those found on this OIG sanctions list may not perform services or provide goods related to Medicare, Medicaid or other healthcare programs.
How many types of exclusions are there?
OIG Exclusions are classified into two main categories: mandatory and permissive. Each have their own sub-types and corresponding penalties.[1] Mandatory exclusions compels the OIG under the law to exclude those convicted of criminal offenses connected to federal or state healthcare programs. Permissive exclusions are at the sole discretion of the OIG whether to place those guilty of misdemeanors related to federal or state healthcare programs under the LEIE. This includes reasons connected to professional competence, default in education loan obligations and financial integrity issues, among others.
How long do OIG exclusions last?

Mandatory exclusions can last depending on the number of offenses:[2]

● Five years (1st offense)
● Ten years (2nd offense)
● Permanent exclusion (3rd offense)

Permissive exclusions, on the other hand, can last at the discretion of the OIG. Placement on the OIG Exclusion database could be anywhere between one to three years.[3]

Can those on the OIG Exclusion list (LEIE) charge federal healthcare programs for their goods or services?
No, they may not. Individuals or entities on OIG Exclusion lists may not bill federal healthcare programs for any item or service furnished while on this OIG sanction list. This extends to prescribing medications as well as administrative or management services.
How do you get out of the LEIE?
The only way is through a reinstatement procedure which is not automatic. Your period of exclusion may have already ended however you must still apply for reinstatement.

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