Healthcare Exclusion & Sanction Screening
Screen individuals and entities against OIG LEIE, SAM.gov, and state Medicaid exclusion lists in one call.
The problem
Federal law requires healthcare organizations to screen every employee, contractor, and vendor against the OIG List of Excluded Individuals/Entities (LEIE), the SAM.gov Exclusions list, and every applicable state Medicaid exclusion list — before hire, and monthly after that, for as long as that person or vendor is on staff. Employing an excluded person while billing federal healthcare programs carries penalties of $10,000–$20,000 per item or service, plus repayment and False Claims Act exposure. There is no single government source for this check: OIG publishes a monthly CSV with no API, and each state that maintains its own Medicaid exclusion list publishes it in its own format. A mid-sized organization can lose 10-15 hours a month running this by hand.
Who it's for
Compliance officers, credentialing teams, and HR systems at hospitals, physician groups, home health agencies, pharmacies, and any organization that bills Medicare or Medicaid and needs monthly exclusion re-screening as part of its compliance program.
Use cases
- Pre-hire exclusion screening as part of a credentialing workflow
- Monthly re-screening of an existing employee or vendor roster
- Vendor and contractor onboarding checks before granting facility or billing access
- Batch roster screening ahead of a compliance audit
What it does
Send a name — optionally with a date of birth and/or National Provider Identifier (NPI) for corroboration — and get back potential matches from OIG LEIE, SAM.gov Exclusions, and California and New York's state Medicaid exclusion lists, plus optional identity confirmation against the official NPI registry, all in one call. A batch endpoint screens up to 25 subjects per request for roster-style checks. Every response includes a per-source manifest showing whether that section came from live government data, so you always know exactly what you're looking at.
Why Aervik's implementation is different
Every hit is reported as a "potential match requiring human verification" — never asserted as a confirmed exclusion. If a supplied date of birth or NPI conflicts with a record, the match is still returned rather than silently filtered, since the corroborating field itself could be the one that's wrong. Coverage is disclosed plainly rather than rounded up: this API currently covers OIG LEIE, SAM.gov, and two states' Medicaid exclusion lists (California and New York) out of the roughly 40+ states that maintain their own list, and that gap is stated on every response, never hidden behind a clean-looking "no match."
Example
Request
POST /screen
{ "name": "Jane Doe", "dob": "1985-05-05", "npi": "1063837144" }
Response
{
"input": { "name": "Jane Doe", "dob": "1985-05-05", "npi": "1063837144" },
"sources": {
"oig_leie": { "status": "no_match", "matches": [], "source": { "basis": "live", "as_of": "2026-08-27" } },
"sam_gov": { "status": "no_match", "matches": [], "source": { "basis": "live", "as_of": "2026-08-27" } },
"state_ca": { "status": "no_match", "matches": [], "source": { "basis": "live", "as_of": "2026-08-27" } },
"state_ny": { "status": "no_match", "matches": [], "source": { "basis": "live", "as_of": "2026-08-27" } },
"state_tx": { "status": "no_match", "matches": [], "source": { "basis": "mock", "as_of": "2026-08-26" } }
},
"overall": {
"status": "no_potential_matches_found",
"total_matches": 0,
"incomplete_coverage": true
},
"disclaimer": "Advisory only, not a certified or exhaustive exclusion determination."
}
Key features
- One call covers OIG LEIE, SAM.gov Exclusions, and California and New York Medicaid exclusion lists
- Optional NPI cross-check against the official NPI registry
- Batch endpoint for roster-style screening, up to 25 subjects per call
- Every match includes a plain-language reason, never a bare score
- A per-source freshness manifest on every response — no result is ever presented as live when it isn't
Pricing
A free tier covers light testing. Paid tiers scale from a few hundred to tens of thousands of monthly screens, with overage priced per additional screen beyond your plan's included volume — sized for anything from a single credentialing team to a multi-site health system.
Coverage today: OIG LEIE, SAM.gov Exclusions, and the California and New York Medicaid
exclusion lists are live against real government data. Texas’s exclusion list exists but
has no automatable download path yet, so that source ships as a clearly-labeled
placeholder rather than a silent gap. GET /sources always returns the current, honest
coverage picture — check it before relying on any result.
This API is advisory only. A “no potential matches found” result is never a certified
clearance, and every match requires independent human verification before any hiring,
credentialing, or billing decision. See the API’s own /terms endpoint for the full
disclosure and disclaimer.
Want to try a single lookup before integrating? Use the free Healthcare Exclusion Lookup tool — same real government data, one name at a time, no signup. It’s rate-limited and not meant for bulk or production use; use the API above for that.