OIG LEIE Checks
An OIG LEIE Check is a check of the Department of Health and Human Services (DHHS) Office of the Inspector General’s List of Excluded Individuals and Entities (LEIE). An OIG LEIE is a list of individuals excluded from federally funded health care programs pursuant to the OIG’s authority under the Social Security Act. Anyone who hires an individual on the LEIE may be subject to civil monetary penalties (CMP). To avoid CMP liability, health care entities need to routinely check the LEIE to ensure that new hires and current employees are not on the excluded list. Exclusions must be imposed for numerous reasons, including without limitation: criminal convictions for or related to Medicare, Medicaid, SCHIP, or other State health care program fraud, or patient abuse or neglect; felony criminal convictions for other health care-related fraud, theft, or other financial misconduct; and other criminal convictions relating to unlawful manufacture, distribution, prescription, or dispensing of controlled substances. Exclusions may also be imposed for other reasons, including without limitation: misdemeanor convictions related to health care fraud or fraud in a program funded by any federal, state or local government agency; the unlawful manufacture, distribution, prescription, or dispensing of controlled substances; suspension, revocation, or surrender of a license to provide health care for reasons bearing on professional competence or performance, or financial integrity; provision of unnecessary or substandard services; submission of false or fraudulent claims to a federal health care program; engaging in unlawful kickback arrangements; defaulting on health education loan or scholarship obligations; and controlling a sanctioned entity as an owner, officer, or managing employee. Check results include as applicable and available: name, address, date of birth, professional classification and specialty, exclusion type, exclusion date and reinstatement date. Results may be name match only due to limited identifiers in the database. The database is updated by the OIG monthly. Average turnaround time is same day to 1 business day.
OIG LEIE Database (Medical Exclusion List)
This search contains the Office of Inspector General’s (OIG) list of excluded individuals and entities that are prohibited from participating in any federally funded health care program. It must be used for any healthcare business that participates in Medi-Care or other federally funded health programs. Data updated monthly and may include professional classification, specialty, exclusion type, and exclusion and reinstatement dates.
OIG LEIE Plus (Level 1)
This search contains the Office of Inspector General’s (OIG) list of excluded individuals and entities that are prohibited from participating in any federally funded health care program. It must be used for any healthcare business that participates in Medi-Care or other federally funded health programs. Data updated monthly and may include professional classification, specialty, exclusion type, and exclusion and reinstatement dates.
OIG LEIE Plus One State (Level 2)
This search contains all of the same data from the Level 1 product. It also includes state specific board issued sanctions and disciplinary actions from the selected state.
OIG LEIE Plus All State (Level 3)
An OIG LEIE Plus Level 3 is a check of one name in: the U.S. Department of Health and Human Services. This search contains all of the same data from the Level 1 product along with a search against the entire FACIS data set which includes state board issued sanctions and disciplinary actions. There are approximately 2,500 primary sources, with 800+ taxonomies in 56 jurisdictions. It is the most comprehensive of all the LEIE products.
Colorado Adult Protective Services (CAPS) Check
A search of the Colorado Adult Protective Services (CAPS) database to determine whether an
employment applicant has been substantiated of physical abuse, sexual abuse, caretaker neglect or exploitation of an at-risk adult. Employer must first register with the Colorado CAPS check unit and provide the specific CAPS employer ID to ClearStar prior to submitting any requests. Average turn around time: 5 days or less