Healthcare Data GlossaryRegulatory
OIG Exclusion: Definition and Healthcare Context
Full name: OIG Exclusion from Federal Health Care Programs
An OIG exclusion is a formal administrative sanction imposed by the HHS Office of Inspector General that prohibits an individual or entity from participating in Medicare, Medicaid, and all other federally funded health care programs. Mandatory exclusions are required by statute — for example, felony convictions for health care fraud. Permissive exclusions are at the OIG's discretion. Excluded parties cannot receive federal program payment directly or through an employer. Exclusion records are published in the LEIE.
Last updated: 2026-06-17Reviewed by: Dr. Jennifer Montecillo, MD — Gullas College of Medicine, 2019. Non-practicing medical reviewer.
How it’s used
- OIG LEIE (oig-leie): each OIG exclusion record includes the exclusion type, basis, effective date, and — where available — NPI for cross-referencing against provider records.
- CMS NPPES NPI Registry: Fonteum cross-references NPPES provider records against the LEIE to surface exclusion flags in the provider data graph.
Frequently asked questions
- What is an OIG exclusion?
- An OIG exclusion bars an individual or organization from participating in Medicare, Medicaid, and all other federal health care programs.
- What are the types of OIG exclusions?
- There are two types: mandatory exclusions (required by statute, such as for felony convictions) and permissive exclusions (at OIG's discretion, such as for license revocations).
- How long does an OIG exclusion last?
- Mandatory exclusions have a minimum five-year period. The specific duration depends on the nature of the offense; some exclusions are permanent.
Explore in Fonteum
How Fonteum sources, resolves, and publishes data tied to this term.