Why Every Healthcare Employer Must Check the OIG Exclusion List
In April 2025, Advancare Healthcare Services in Illinois was fined $41,0000. The reason? For hiring someone who was excluded from participating in federal healthcare programs. The OIG Exclusion List is a federal list of people and companies who aren’t allowed to work in jobs funded by Medicare or Medicaid. If a hospital or clinic hires someone on the list, they can pay huge penalties, even if they didn’t know the person was on it.
States often have their own exclusion lists too, but the OIG list is the main federal list all healthcare employers are required to check. While the $41,000 fine might sound like a one-off compliance mistake. It highlights a larger issue: healthcare employers failing to verify exclusion status.
What Happened?
According to the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Advancare employed a registered nurse on the OIG list. This person had been formally excluded from working in any capacity that touches federal healthcare dollars — including Medicare and Medicaid.
Despite the nurse’s excluded status, the individual went on to provide services that were billed to federal programs. A clear violation of the Civil Monetary Penalties Law (CMP). The result? A financial penalty and a public enforcement action now listed on the OIG website.
What Is an Excluded Individual?
An excluded individual is someone barred from participating in federal healthcare programs. This could be due to previous fraud, abuse, licensing issues, or other serious violations. Employers are legally barred from hiring excluded individuals for any role that involves patient care, billing, or administrative support tied to federal reimbursements.
Hiring an excluded person, even unknowingly, can result in:
- Civil monetary penalties (CMPs)
- Repayment of improper claims
- Damage to your organization’s reputation
- Potential exclusion of your own business from federal programs
The Problem: A Preventable Oversight
This case isn’t unique. Every year, the OIG issues dozens of similar enforcement actions. The violation could have been avoided by performing one simple, routine check: searching the OIG Exclusions Database.
What Should Employers Do?
If you’re in healthcare, home care, or any field that bills federal programs, you should:
- Check every employee and contractor against the OIG Exclusion List (LEIE) before hiring.
- Conduct follow up checks yearly.
- Document each check to create a compliance trail.
- Use a background screening partner that includes exclusion monitoring as part of their process.
Sure Check Can Help
At Sure Check, we specialize in healthcare-specific background screening, including:
- OIG Exclusion List checks
- SAM.gov and Medicare exclusion searches
- Abuse and sex offender registry checks
- Continuous monitoring to catch mid-employment exclusions
Don’t risk your business on a missed detail. Advancare’s $41K penalty is a warning shot to every employer in the space.
Let us help you hire with confidence and stay compliant.