OIG Exclusion Check: Screen NPIs Against the LEIE
Pricing
$3.00 / 1,000 results
OIG Exclusion Check: Screen NPIs Against the LEIE
Screen a roster of NPIs against the HHS OIG exclusion list (LEIE). One row per NPI: excluded yes/no, exclusion type, date, and plain-English reason. Schedule it monthly for recurring re-screening. $3 per 1,000 NPIs checked.
Pricing
$3.00 / 1,000 results
Rating
0.0
(0)
Developer
Aaron Melton
Maintained by CommunityActor stats
0
Bookmarked
2
Total users
1
Monthly active users
a day ago
Last modified
Categories
Share
OIG Exclusion Check by NPI
Paste or upload a list of NPIs. Get one row back per NPI: whether that provider appears on the HHS OIG List of Excluded Individuals/Entities (LEIE), and if so, the exclusion type, effective date, a plain-English reason (mapped from the statutory codes), and reinstatement date if any. Every response includes the LEIE publication date it was checked against.
Three results, never a silent miss
Every NPI you submit returns exactly one row with one of three results in the exclusion_check field:
- excluded: the NPI matches an LEIE exclusion record (reinstatement date included when one exists)
- clear: the provider exists in the registry and has no NPI-matched LEIE exclusion
- indeterminate: the NPI could not be found at all
An NPI we cannot find is reported as indeterminate, never as clear. Your compliance filter can key on that one field without ever mistaking an unknown for a pass.
Every row tells you who was checked
Each NPI resolves against our normalized copy of the full NPPES registry (9.4M providers), so every result row carries the provider's name (or business name) and practice state alongside the exclusion result. When a check flags a hit, your reviewer can confirm it is the right person on your roster, not just a matching number. Screeners that check the LEIE file alone cannot do this at roster scale.
Why screen monthly
Exclusion screening is not a one-time task. Federal guidance requires checking exclusion lists monthly for Medicaid-participating organizations (42 CFR 455.436), and NCQA credentialing standards now expect monthly screening as well. The OIG updates the LEIE monthly. This actor is built for that cadence: use Apify's built-in scheduling to run your roster automatically every month and land the results in the same dataset.
Typical uses
- Scrub a marketing or outreach list of sanctioned providers before a campaign
- Monthly re-screen of an active provider roster for compliance workflows
- Pre-engagement checks on referral or partner lists
What this checks, and what it does not
This actor checks the LEIE by NPI match. Two honest limitations you should know:
- LEIE coverage by NPI is partial. Many LEIE records, mostly older exclusions, were recorded without an NPI. An NPI-based check cannot match those records. A clean result here means "no NPI-matched LEIE exclusion," not "this person has never been excluded."
- The LEIE is one list. Full regulatory screening programs also check SAM.gov and state Medicaid exclusion lists, and match on name and date of birth as well as identifiers.
This actor complements a full multi-source screening program. It does not replace one. It is built for fast, cheap, recurring NPI-level checks at bulk scale, not as certified compliance tooling.
Use from AI agents (MCP)
This actor works as an MCP tool out of the box. Point your agent at mcp.apify.com with this actor enabled and it can screen NPIs directly ("check these 200 NPIs against the OIG exclusion list"). Results land in a dataset your agent can read back.
Pricing
$3 per 1,000 NPIs checked ($0.003 per row). Every NPI you submit returns exactly one row (excluded, clear, or indeterminate), and each row is one billable event. A 5,000-provider monthly roster re-screen costs $15/month.
Data source
HHS OIG LEIE (public, updated monthly by OIG) joined against the CMS NPPES registry. Provider enrollment data only; no patient data, no HIPAA scope.
