OIG LEIE Sanctions Screening for Medical Practices

Federal law requires monthly LEIE screening for all employees, contractors, and vendors who could be involved in a Medicare or Medicaid claim. Many states (e.g., NY, TX) also require state-specific exclusion checks against their Medicaid OIG lists. GuardWell currently covers federal LEIE; state lists are on the roadmap.

Civil Monetary Penalties of up to $20,000 per item or service plus 3x the amount claimed under federal damages. The practice (not just the individual) is liable. The OIG and DOJ aggressively pursue these cases — this is one of the most common 'gotcha' compliance failures and one of the easiest to prevent with monthly screening.

You can — they're great. They charge $300–$800/month for a practice your size. GuardWell includes monthly LEIE screening as part of the base $199/mo subscription. If you need state-specific Medicaid OIG lists or sanctions screening across hundreds of additional federal lists, those tools cover more — but for the core federal LEIE obligation that hits every small practice, GuardWell is included.

Common names produce false-positive matches frequently in healthcare (e.g., 'John Smith' matches dozens of LEIE rows). When you mark a match false-positive, GuardWell caches the unique combination of (practice, sanctioned individual, your staff/vendor) so the same false hit never re-appears in your queue, even on next month's run.

Yes. Add the staff member, then click 'Trigger screening' in /programs/sanctions to run an immediate per-practice screening. This satisfies the pre-hire screening requirement without waiting for the monthly cron.

SAM federal exclusions (System for Award Management) are NOT in scope at v1. OIG LEIE only. Most small medical practices that don't bid on federal contracts are not affected by SAM. If your practice does federal-contract work, plan to use a dedicated tool for SAM in addition to GuardWell.