It’s time for smarter exclusion monitoring.
We deliver healthcare’s most trusted ongoing OIG exclusion monitoring and state Medicaid exclusion monitoring for every population.
What makes our exclusion monitoring smarter than anyone else's?
Fully Automated Ongoing Exclusion Monitoring
Our exclusion monitoring solution is fully automated, screening your employees, providers, and vendors against every state and federal exclusion source every single day. We screen every individual or entity across the OIG LEIE, SAM/GSA and all 42 state Medicaid exclusion lists continuously to ensure we catch every exclusion as quickly as possible to power critical business processes and keep people safe. Our solution is always audit and survey-ready, and for extra peace of mind we guarantee our work with a $10 million E&O policy.
Exact-Match Verification - No More False-Positives
Our best-in-class monitoring science verifies every potential exclusion result on a continuous basis, delivering you exact-matches – confirmed, actionable results to empower faster, more informed decisions about provider and employee eligibility.
Even Better Than the Primary Source
We enrich both primary source data and our client’s data records with identifiers to catch and verify issues no one else can, alerting clients to issues they would never otherwise find. From the beginning, we set out to do healthcare monitoring better than anyone else, so we aggregated, cleaned, and enriched primary source data until our proprietary dataset was smarter than the original sources.
Seamless Integrations Designed to Scale
We’ve designed flexible exclusion monitoring solutions to integrate into your existing workflows, both within our software suite and through our powerful APIs. Enterprise healthcare organizations integrate our solution into their systems of record, such as an HRIS, referral management software, or a claims processing system.
Healthcare Exclusion Data
We’ve made it easy to see the risk of healthcare exclusions across the country.Each month, we update our Exclusion Map with data from all federal and state exclusion or terminated provider lists.
Discover each state’s metrics by clicking on the interactive map.
Alabama Exclusion Data
Total Exclusions: 1,928
Source: Alabama Exclusion List
Format: Electronic
Update Schedule: Monthly
Alaska Exclusion Data
Total Exclusions: 270
Source: Alaska Exclusion List
Format: Electronic
Update Schedule: Monthly
Arizona Exclusion Data
Source: Arizona Exclusion List
Format:
Update Schedule: List No Longer Maintained
Arkansas Exclusion Data
Total Exclusions: 1,647
Source: Arkansas Exclusion List
Format: Electronic
Update Schedule: Monthly
California Exclusion Data
Total Exclusions: 19,872
Source: California Exclusion List
Format: Electronic
Update Schedule: Monthly
Colorado Exclusion Data
Total Exclusions: 189
Source: Email Request Only
Format: Electronic
Update Schedule: Monthly
Connecticut Exclusion Data
Total Exclusions: 52
Source: Connecticut Exclusion List
Format: Electronic
Update Schedule: Monthly
Delaware Exclusion Data
Total Exclusions: 269
Source: Email Request Only
Format: Electronic
Update Schedule: Monthly
District of Columbia Exclusion Data
Total Exclusions: 24
Source: District of Columbia Exclusion List
Format: Electronic
Update Schedule: Monthly
Florida Exclusion Data
Total Exclusions: 1,437
Source: Florida Exclusion List
Format: Electronic
Update Schedule: Monthly
Georgia Exclusion Data
Total Exclusions: 1,231
Source: Georgia Exclusion List
Format: Electronic
Update Schedule: Monthly
Hawaii Exclusion Data
Total Exclusions: 221
Source: Hawaii Exclusion List
Format: Electronic
Update Schedule: Monthly
Idaho Exclusion Data
Total Exclusions: 143
Source: Idaho Exclusion List
Format: Electronic
Update Schedule: Monthly
Illinois Exclusion Data
Total Exclusions: 2,504
Source: Illinois Exclusion List
Format: Electronic
Update Schedule: Monthly
Indiana Exclusion Data
Total Exclusions: 95
Source: Indiana Exclusion List
Format: Electronic
Update Schedule: Monthly
Iowa Exclusion Data
Total Exclusions: 779
Source: Iowa Exclusion List
Format: Electronic
Update Schedule: Monthly
Kansas Exclusion Data
Total Exclusions: 56
Source: Kansas Exclusion List
Format: Electronic
Update Schedule: Monthly
Kentucky Exclusion Data
Total Exclusions: 216
Source: Kentucky Exclusion List
Format: Electronic
Update Schedule: Monthly
Louisiana Exclusion Data
Total Exclusions: 4,517
Source: Louisiana Exclusion List
Format: Electronic
Update Schedule: Monthly
Maine Exclusion Data
Total Exclusions: 990
Source: Maine Exclusion List
Format: Electronic
Update Schedule: Monthly
Maryland Exclusion Data
Total Exclusions: 1,506
Source: Maryland Exclusion List
Format: Electronic
Update Schedule: Monthly
Massachusetts Exclusion Data
Total Exclusions: 210
Source: Massachusetts Exclusion List
Format: Electronic
Update Schedule: Monthly
Michigan Exclusion Data
Total Exclusions: 2,733
Source: Michigan Exclusion List
Format: Electronic
Update Schedule: Monthly
Minnesota Exclusion Data
Total Exclusions: 1,173
Source: Minnesota Exclusion List
Format: Electronic
Update Schedule: Monthly
Mississippi Exclusion Data
Total Exclusions: 173
Source: Mississippi Exclusion List
Format: Electronic
Update Schedule: Monthly
Missouri Exclusion Data
Total Exclusions: 183
Source: Missouri Exclusion List
Format: Electronic
Update Schedule: Monthly
Montana Exclusion Data
Total Exclusions: 120
Source: Montana Exclusion List
Format: Electronic
Update Schedule: Monthly
Nebraska Exclusion Data
Total Exclusions: 1,035
Source: Nebraska Exclusion List
Format: Electronic
Update Schedule: Monthly
Nevada Exclusion Data
Total Exclusions: 693
Source: Nevada Exclusion List
Format: Electronic
Update Schedule: Monthly
New Hampshire Exclusion Data
Total Exclusions: 47
Source: New Hampshire Exclusion List
Format: Electronic
Update Schedule: Monthly
New Jersey Exclusion Data
Total Exclusions: 3,808
Source: New Jersey Exclusion List
Format: Electronic
Update Schedule: Monthly
New York Exclusion Data
Total Exclusions: 7,586
Source: New York Exclusion List
Format: Electronic
Update Schedule: Monthly
North Carolina Exclusion Data
Total Exclusions: 65
Source: North Carolina Exclusion List
Format: Electronic
Update Schedule: Monthly
North Dakota Exclusion Data
Total Exclusions: 154
Source: North Dakota Exclusion List
Format: Electronic
Update Schedule: Monthly
Ohio Exclusion Data
Total Exclusions: 1,645
Source: Ohio Exclusion List
Format: Electronic
Update Schedule: Monthly
Pennsylvania Exclusion Data
Total Exclusions: 4,095
Source: Pennsylvania Exclusion List
Format: Electronic
Update Schedule: Monthly
South Carolina Exclusion Data
Total Exclusions: 859
Source: South Carolina Exclusion List
Format: Electronic
Update Schedule: Monthly
Tennessee Exclusion Data
Total Exclusions: 17
Source: Tennessee Exclusion List
Format: Electronic
Update Schedule: Monthly
Texas Exclusion Data
Total Exclusions: 10,904
Source: Texas Exclusion List
Format: Electronic
Update Schedule: Monthly
Vermont Exclusion Data
Total Exclusions: 38
Source: Vermont Exclusion List
Format: Electronic
Update Schedule: Monthly
Washington Exclusion Data
Total Exclusions: 228
Source: Washington Exclusion List
Format: Electronic
Update Schedule: Monthly
West Virginia Exclusion Data
Total Exclusions: 99
Source: West Virginia Exclusion List
Format: Electronic
Update Schedule: Monthly
Wyoming Exclusion Data
Total Exclusions: 110
Source: Wyoming Exclusion List
Format: Electronic
Update Schedule: Monthly
HHS OIG LEIE
Total Exclusions: 74,564
SAM.gov Database
Total Exclusions: 70,485
State Exclusion Data
Total Exclusions: 73,941
An Interactive Guide to Selecting an Exclusion Monitoring Solution
What should you be looking for in an exclusion monitoring solution? Explore what separates the best from the rest in this interactive guide!
OIG Exclusion Monitoring FAQ
An exclusion is an administrative action taken against an individual or entity by the Dept. of Health and Human Services (HHS), Office of Inspector General (OIG) or a State Medicaid Agency.
OIG imposes exclusions under the authority of sections 1128 and 1156 of the Social Security Act. If an individual or entity is excluded, they are prohibited from participating in reimbursements for or from federally funded healthcare programs through the Centers for Medicare and Medicaid Services (CMS). Once an individual or entity is excluded, they are considered excluded in all states.
Healthcare organization who bill federal and state healthcare programs should be checking both federal and state Medicaid exclusion lists. The two federal exclusion sources are OIG LEIE and the SAM.gov database.
There are currently 42 state Medicaid excluded/sanctioned/terminated provider lists. Each list is updated and distributed at different intervals and in various formats, making it difficult to verify and screen without a third party.
Exclusion data is messy, incomplete, and varies greatly by source. Our verification tools use sorting algorithms and advanced data grouping to make a more complete profile for providers, employees, healthcare vendors, and more which is not present on government databases or registries. ProviderTrust maintains a proprietary grid of excluded individuals and entities that enhances state and federal exclusion data with additional unique identifiers and additional information (such as license number, NPI, former names, etc.).
