Healthcare Orgs Fined for Employing Nurses on the HHS-OIG Exclusion List
This month, the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) agreed to settlements with two healthcare providers who employed nurses on the HHS-OIG exclusion list, who provided items or services that were billed to federally funded healthcare programs.
The exclusion list, formally known as the List of Excluded Individuals and Entities (LEIE), contains entities and individuals excluded from participating in federally funded healthcare programs. The exclusion list was established to prevent fraud, waste, and abuse in federally funded healthcare programs. If an individual or entity has been added to the list, they are not permitted to participate in federally funded healthcare programs in any capacity.
There are many different reasons for exclusion, including fraud convictions, patient abuse and neglect, felony drug convictions, submission of false claims, and participation in illegal kickback schemes. Certain violations carry a mandatory minimum exclusion period, with HHS-OIG having discretion over how long an entity or individual remains on the list. While it is possible to be removed from the list after the minimum term has expired, the excluded company/individual must complete a formal reinstatement process, which can take some time.
Prior to hiring any individual or onboarding a new supplier, healthcare organizations need to review the exclusion list to make sure the company or individual has not been excluded. The responsibilities do not end there, as if an individual or company is added to the exclusion list after hiring/onboarding, penalties can be imposed for continuing to employ that individual or the continued use of a company’s services. Regular screenings of the workforce should be conducted, along with monthly checks of vendors to ensure OIG compliance. Many companies choose to ease this compliance headache by using automated screening and other third-party compliance services.
HHS OIG Exclusions List
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In April 2025, two companies were discovered to have failed to conduct exclusion list checks, resulting in the employment of excluded individuals. Advancare Healthcare Services in Lombard, Illinois, was discovered to have employed a registered nurse who was on the exclusion list and had been barred from participating in federally funded healthcare programs. The nurse had provided items or services that were billed to Medicare or Medicaid. Advancare Healthcare Services agreed to settle the alleged exclusion list violation, paid a $41,596.68 penalty, and was required to terminate the nurse’s employment.
Associated Clinicians of East Texas, PLLC, which does business as Diagnostic Clinic of Longview, was discovered to have employed a licensed vocational nurse who had been added to the exclusion list. The nurse provided items or services billed to federally funded healthcare programs. Diagnostic Clinic of Longview agreed to settle the alleged violation, paid a $77,877.45 financial penalty, and was required to terminate the nurse’s employment.
