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Illinois exclusion screening requirements
If your organization bills Medicare or Illinois Medicaid, you're expected to make sure no one on your staff is excluded from federal or state health care programs. Here's what to check and how often.
Last reviewed October 2026. General information, not legal advice.
The federal lists every healthcare employer should check
- HHS-OIG List of Excluded Individuals/Entities (LEIE). People and businesses excluded from Medicare, Medicaid and other federal health care programs.
- SAM.gov exclusions. People and businesses barred from federal programs and contracts.
In State Medicaid Director Letter #09-001 (January 2009), CMS told states to direct Medicaid providers to screen their employees and contractors against the LEIE when they hire or contract with them, and then every month, because new names are added every month.
Medicare and Medicaid won't pay for items or services furnished, ordered or prescribed by an excluded person. An employer that pays an excluded person with federal health care program money can owe the money back and face civil money penalties.
Illinois's own Medicaid exclusion list
The Department of Healthcare and Family Services Office of Inspector General (HFS-OIG) keeps the HFS-OIG Provider Sanctions List. Its legal basis is 305 ILCS 5/12-4.25 and Title 89 of the Illinois Administrative Code. Official Department of Healthcare and Family Services Office of Inspector General (HFS-OIG) page.
- The list names providers and individuals who are terminated, suspended, barred or otherwise excluded from the Illinois Medical Assistance Program.
A person can appear on a state list without appearing on the federal ones, so Illinois employers should check all three.
A simple monthly routine
- Before hiring or contracting, check the person against the LEIE, SAM.gov and the Illinois list.
- Every month, re-check everyone. Lists change monthly, and someone hired clean can be added later.
- Keep dated proof of every check for auditors, payers and surveyors.
- If a name matches, confirm it on the official list (date of birth, address, NPI) before acting. Many matches are a different person with the same name.
How StaffScreen helps
StaffScreen checks every name on your staff list against the LEIE and SAM.gov every month and emails you a dated certificate for your compliance file. Want the HFS-OIG Provider Sanctions List checked too? It's included at no extra cost: just ask after you sign up.