OIG Exclusion Compliance
The Office of Inspector General (OIG) protects federal healthcare programs from fraud and abuse.
Learn how SureCheckUSA helps you stay complaint and avoid costly penalties.
OIG – Office of Inspector General
The Office of Inspector General (OIG) is the enforcement arm of the U.S. Department of Health and Human Services (HHS). Established to protect the integrity of federal health care programs, the OIG works to detect, investigate, and prevent fraud, waste, and abuse in programs such as Medicare and Medicaid.
Their mission is twofold: protect taxpayer dollars from misuse and ensure beneficiaries receive proper, ethical care. This includes everything from auditing billing practices to prosecuting those who attempt to exploit the system. The OIG’s work not only safeguards federal funds, but also helps maintain public trust in the healthcare system.
OIG’s Efforts to Curb Fraud
Conducting criminal, civil, and administrative investigations of fraud and misconduct in HHS programs.
Using advanced tools and technologies in nationwide audits and investigations.
Imposing program exclusions and civil penalties for criminal activity such as fraud or abuse.
Negotiating settlements and integrity agreements under the False Claims Act.
Why This Matters
Organizations that fail to screen employees, contractors, and vendors against the OIG’s exclusion list risk substantial fines and reputational damage. Improperly billing Medicare or Medicaid for services provided by individuals or vendors currently excluded may result in significant fines. Monthly exclusion screenings are essential to staying compliant.
Recent OIG Fines & Exclusions
The Office of Inspector General (OIG) actively enforces penalties against healthcare providers and organizations that bill Medicare or Medicaid for services involving excluded individuals or entities. Below is a snapshot of recent enforcement actions, followed by major national takedowns.
Major National Takedowns
Over the past decade, HHS-OIG and law enforcement partners have carried out some of the largest health care fraud takedowns in U.S. history — involving billions in false claims
and thousands of provider exclusions.
Read our full post for details on these nationwide enforcement actions and their impact on healthcare compliance.
OIG enforcement is increasing year after year. Regular exclusion checks protect organizations from costly penalties and reputational damage. SureCheckUSA’s automated screening service covers federal and state databases to help you stay compliant.
Medicaid Fraud Control Units Fiscal Year 2019 Annual Report
03-27-2020 | OEI-09-20-00110 | Complete Report | Statistical Chart | Interactive Map OIG Medicaid Fraud Control Units (MFCUs or Units) investigate and prosecute Medicaid provider fraud and patient abuse or [...]
OIG Medicaid Fraud Control Units Fiscal Year 2018 Annual Report
03-25-2019 | Report (OEI-09-19-00230) | Complete Report | Statistical Chart | Interactive Map OIG Medicaid Fraud Medicaid Fraud Control Units (MFCUs or Units) investigate and [...]
OIG Medicaid Fraud Control Units Fiscal Year 2017 Annual Report
3-30-2018 | Report (OEI-09-18-00180) | Complete Report OIG Medicaid Fraud Related Content Interactive Map Statistical Chart Medicaid Fraud Control Units (MFCUs or Units) investigate and [...]
Medicaid Fraud Control Units Fiscal Year 2016 Annual Report
05-17-2017 | Report (OEI-09-17-00210) | Complete Report OIG Medicaid Fraud WHY WE DID THIS STUDY The Department of Health and Human Services (HHS) OIG is [...]
Medicaid Fraud Control Units Fiscal Year 2015 Annual Report
09-13-2016 | Report (OEI-07-16-00050) | Complete Report OIG Medicaid Fraud WHY WE DID THIS STUDY The Department of Health and Human Services (HHS) OIG is [...]
Medicaid Fraud Control Units Fiscal Year 2014 Annual Report
04-20-2015 | Report (OEI-06-15-00010) | Complete Report OIG Medicaid Fraud WHY WE DID THIS STUDY The Department of Health and Human Services (HHS) OIG is [...]
Medicaid Fraud Control Units Fiscal Year 2013 Annual Report
03-07-2014 | Report (OEI-06-13-00340) | Complete Report OIG Medicaid Fraud WHY WE DID THIS STUDY The Department of Health and Human Services (HHS) OIG is [...]
Automated Monthly Exclusion Screening Made Simple
SureCheckUSA provides secure, automated monthly exclusion and sanction screening across federal and state data sources — including LEIE, SAM, OFAC, FDA, Medicare Opt-Out, and all available state exclusion lists. Our solution reduces compliance risk by identifying excluded individuals and entities before they impact your organization.
Why Choose SureCheckUSA?
- Staff Efficiency
Manual exclusion screening is time-consuming and error-prone. SureCheckUSA automates the process, freeing up your team’s time and reducing administrative burden. - Financial
Avoid fines and penalties by ensuring excluded individuals and entities are identified before claims are submitted. Our system helps protect your organization from costly compliance violations. - Comprehensive Coverage
We check all relevant federal and state exclusion lists monthly, and provide bi-monthly compliance status notifications for any positive matches. - Full Resolution Support
Our experienced team handles all necessary resolutions of search results, so your staff doesn’t have to. - Transparent Reporting
Enjoy unlimited access to current and archived reports, with clear documentation of screening results.
Note: Organizations using exclusion screening services must comply with the Fair Credit Reporting Act and applicable federal, state, and local requirements, including providing employees or applicants with a copy of results where required.
