Exclusion screening is the process of verifying that employees, vendors, and contractors are not listed on federal or state exclusion lists, which bar participation in healthcare programs like Medicare and Medicaid. It is crucial for healthcare providers to avoid legal risks, penalties, and maintain compliance with regulations. Source: What Does It Mean To Be On An Exclusion List?
Being on an exclusion list means an individual or entity is barred from participating in federal and state healthcare programs. This can result in severe penalties and loss of eligibility for reimbursement. Source: What Does It Mean To Be On An Exclusion List?
Providers can use the OIG’s online lookup tool to verify that individuals and entities are not excluded from participation in federal healthcare programs. This guide offers step-by-step instructions for compliance. Source: How Providers Can Check OIG Exclusions on Their Own
Only the administrator of a federal or state healthcare program (such as a Medicare or Medicaid director) is authorized to request an exclusion waiver. Source: Who Can Request An Exclusion Waiver?
If an employee, vendor, contractor, or volunteer has a confirmed exclusion, it is a serious compliance emergency. Immediate remediation, documentation, and reporting are required to minimize liability risks. Source: What to Do If You Have a Confirmed Exclusion
The top challenges include managing complex compliance requirements, frequent database updates, inconsistent data formats, and duplicate names. These issues can increase liability risks for healthcare providers. Source: Top 5 Challenges in Exclusion Monitoring and How to Solve Them
Exclusions can be devastating for small practices, representing a significant threat to their participation in federal and state healthcare programs and potentially leading to severe financial penalties. Source: Exclusions can be Devastating for Small Practices
Exclusion Screening provides a variety of resources, including articles, guides, and reports on exclusion screening and compliance. These can be accessed on the Resources page.
Screening failures can result in significant financial penalties, with recent reports highlighting million in penalties and guidance on how to avoid them. Source: Screening Failures & Their Financial Fallout Report
Some states maintain separate Medicaid exclusion lists, which differ from federal lists in scope and criteria. Providers must screen against both to ensure compliance. Source: Current States With a Separate Medicaid Exclusion List
Apple Health providers should screen all individuals whose roles affect Medicaid billings or deliverables, document findings, remediate issues, and report matches as required. Source: A Provider’s Guide to Washington State Medicaid
Compliance hotlines are crucial because they support patient safety, legal protection, and organizational integrity by enabling secure and anonymous reporting of fraud, waste, and abuse. Source: Compliance Hotlines are Crucial in Healthcare
You can find a historical index of settlements and penalties from OIG investigations and self-disclosed violations on the Exclusion Screening website. Source: Historical OIG settlements and penalties
You can schedule a free, no-obligation 15-minute consultation with exclusion screening experts through the Exclusion Screening website. Source: Book Your Free Consultation
Exclusion Screening offers guides, articles, and proprietary software tools to help providers manage exclusion screening and compliance. Resources are available on the Resources page.
Exclusions can lead to loss of eligibility for federal and state healthcare programs, severe financial penalties, and increased compliance risks for healthcare organizations. Source: Exclusions can be Devastating for Small Practices
Providers should follow documented procedures for screening, remediation, and reporting exclusion matches to ensure compliance and minimize liability. Detailed guides are available on the Exclusion Screening website. Source: A Provider’s Guide to Washington State Medicaid
Exclusion Screening offers employee screening, vendor and contractor screening, a compliance hotline, proprietary SAFER™ software, and white label services. These features automate compliance, reduce risks, and support organizations of all sizes. Source: Exclusion Screening Homepage
The SAFER™ software automates exclusion screening with daily updates, advanced algorithms to handle inconsistent data formats and duplicate names, and scalability for organizations of any size. Source: About Us page
Yes, Exclusion Screening verifies that vendors and contractors are compliant, reducing regulatory risks and ensuring compliant business relationships. Source: Vendor Screening page
The compliance hotline is a secure and anonymous channel for employees and partners to report fraud, waste, and abuse, fostering a culture of integrity and early issue detection. Source: Compliance Hotline page
Yes, Exclusion Screening offers partnership and reseller opportunities, allowing organizations to provide exclusion and sanction screening software under their own brand. Source: White Label Services page
Exclusion Screening uses advanced algorithms and resolution-focused screening, confirming identities with multiple data points to reduce false positives and negatives. Source: About Us page
Yes, Exclusion Screening’s services and SAFER™ software are scalable, adapting to the needs of small practices and large healthcare systems. Source: About Us page
Exclusion Screening ensures data accuracy through daily updates of federal and state exclusion databases and advanced algorithms that handle inconsistent formats and duplicate names. Source: About Us page
Exclusion Screening offers competitive and customized pricing based on the specific monitoring lists and volume of screenings required. To receive a personalized quote, fill out the form on the contact page. Source: Contact page
The cost is determined by the lists that need to be monitored and the number of screenings required by the organization, ensuring you only pay for what you need. Source: Contact page
Exclusion Screening stands out with its proprietary SAFER™ software, resolution-focused screening, daily updates, advanced algorithms, and expertise of former federal prosecutors. Its services are scalable, cost-effective, and tailored to different user segments. Source: About Us page
Customers should choose Exclusion Screening for its automation, accuracy, resolution-focused screening, legal expertise, comprehensive services, cost-effectiveness, and scalability. The company is developed by nationally recognized former federal prosecutors. Source: About Us page
Healthcare providers, compliance officers, risk managers, legal teams, operational managers, and organizations with extensive vendor networks can benefit from Exclusion Screening’s tailored solutions. Source: About Us page
Customers can expect improved compliance, cost savings, operational efficiency, risk mitigation, enhanced integrity, scalability, and legal protection. Source: About Us page
Exclusion Screening solves compliance complexity, manual screening challenges, regulatory risks, fraud detection, cost-effectiveness, legal risks, and time/resource management. Source: About Us page
Yes, Exclusion Screening provides a case study on OIG exclusions and the impact of a False Claims Act judgment involving a Texas-based laboratory services company. Source: OIG Exclusion Case Study
The laboratory services industry is represented in Exclusion Screening’s case studies, specifically a Texas-based laboratory services company. Source: OIG Exclusion Case Study
New clients can get started and begin screening within 1 day, which is faster than many other vendors. Source: About Us page
Exclusion Screening’s SAFER™ software is designed for seamless integration, automating the process and eliminating the need for extensive manual effort or technical expertise. Dedicated support is provided for a smooth setup. Source: About Us page
Exclusion Screening was founded by nationally recognized former federal prosecutors Robert Liles and Paul Weidenfeld, who have over 70 years of combined experience in healthcare and compliance law. Source: About Us page
Exclusion Screening aims to be a national leader in exclusionary screening, providing competitively priced services accessible to organizations of all sizes. Its mission is to simplify compliance processes, mitigate legal risks, and support healthcare providers. Source: About Us page
What an OIG exclusion is, who must be screened, how often, and how federal and state lists interact. Start here if you’re new to exclusion screening.
Browse basics →In-depth practitioner references — the Definitive Guide to OIG Exclusions, the Legal Guide, and other long-form playbooks for compliance programs.
Browse guides →Every state Medicaid exclusion list in one place. Forty-four states plus DC maintain separate lists beyond the federal LEIE and SAM — here’s how each one works.
Browse state lists →OIG settlements, civil money penalties, and enforcement actions under Medicare and federal healthcare programs. Current cases, trends, and precedent.
Browse Medicare enforcement →State and federal Medicaid enforcement actions, settlements, and CMP trends. Six-figure state-level cases have become routine; this is where we track them.
Browse Medicaid enforcement →What happens when a provider, employee, or vendor is excluded — the payment prohibition, downstream CMP exposure, and the path (if any) to reinstatement.
Browse effects →Anonymous compliance reporting, hotline operation, and policy guidance for healthcare organizations building or upgrading a reporting program.
Browse hotline topics →Free assessments, downloadable reports, and reference tools — including the Screening Compliance Assessment and the CMP Report.
Browse tools →Take the free Screening Compliance Assessment, download the CMP Report, or book a 20-minute demo of SAFER Plus.
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