If your practice bills Medicaid or Denti-Cal, federal law holds you responsible for screening every employee and vendor against the exclusion lists — every month — and proving you did. We run that screen and hand you the dated record. You stay protected.
Most practice owners have never read the statute — and that is exactly the exposure. The obligation to screen does not come from a vendor trying to sell you something. It comes from the Social Security Act and the Code of Federal Regulations, and it has been enforced against practices of every size, including solo physicians and small clinics, for years.
The core rule is simple and unforgiving: no federal health care program will pay for anything furnished, ordered, or prescribed by an excluded person. The moment an excluded individual touches a claim — as a hygienist, a nurse, a biller, a contractor, even a back-office administrator whose work feeds a billable service — every one of those claims becomes a violation. Not a warning. A violation, priced per item.
"OIG's LEIE must be checked on a monthly basis… To avoid CMP liability, health care entities should routinely check the list to ensure that new hires and current employees are not on it."
— HHS Office of Inspector General, Exclusions Program · oig.hhs.gov/exclusionsThere is no version of this where you opt out of the liability. You are responsible the day an excluded person touches a claim — whether the hire was deliberate or an honest oversight. The OIG's enforcement standard is "knew or should have known," and because the LEIE is public and free, the law expects you to have checked — so a good-faith "we didn't realize" unfortunately doesn't lift the liability. That is precisely why a simple, documented monthly screen matters.
It is rarely an investigator at your front door. The exposure surfaces three quiet ways:
1. Automated claims-matching. The OIG and CMS contractors cross-reference submitted claims data against the LEIE by computer. An excluded name on your claims can surface without anyone visiting your office.
2. Routine audits. During a payer or program audit, you are asked to produce your screening records. No dated proof of monthly screening is itself the finding.
3. Whistleblowers. A former employee or competitor reports you — and under the False Claims Act, they share in the recovery, which is why these reports happen.
Sources: HHS-OIG Exclusions Program; OIG Updated Special Advisory Bulletin on the Effect of Exclusion; 42 CFR Parts 1001 & 1003. All linked above resolve to oig.hhs.gov and ecfr.gov.
These are real, publicly documented OIG settlements involving an excluded individual on staff — including small and solo practices, not just hospitals. They are shown as context, not as a scare tactic. You can review the complete, current enforcement record directly on the government's own site.
A simple list of staff, contractors, and vendors — names, plus NPI if you have it. No SSNs, no patient data, ever.
Against the federal exclusion and sanction lists — OIG LEIE, GSA/SAM, and OFAC — and flag the few that need a closer look.
A clean PDF showing who is clear and who to verify — the dated, attributed record an auditor asks for. Every month, on file.
We tell you exactly which few names to confirm at the official source before any action — so you act on certainty, not a name collision.
The large compliance firms were built for hospitals and health systems: per-provider contracts, annual lock-ins, and a sales team that won't return a small practice's call. We were built for the practices they ignore.
Want to see the actual report first? Request a sample. When you're ready, choose your level.
Base covers the federal obligation every billing practice shares. Most owners start here — it's the check the OIG expects and the dated record an auditor asks for first. For many small practices, Base is all they need.
Plus is a tailored engagement for practices whose needs go beyond the federal baseline — additional state-level coverage, larger or multi-location rosters, deeper vendor screening, or audit-response support. Because every practice's situation is different, Plus is arranged by appointment, with a short onboarding step so we scope it correctly. An onboarding fee may apply depending on scope — nothing to worry about now; we confirm everything with you before anything begins.
A full identity-verification tier with SSN confirmation is planned as a later addition to Plus, offered only by appointment and with proper onboarding. It is not part of the current Base service, and we will never ask you to send sensitive identifiers until such a tier is formally in place and agreed with you in writing.
Your roster stays private. We only receive staff or vendor data after you're a client, under a short written agreement that spells out how it's handled — and we don't retain it if you leave. A sample report uses example data, so you can see exactly what you'll get without sending us anything confidential.
Not sure which fits today? Start on Base. You can request a Plus consultation the moment your needs change — and we'll confirm exactly what your state requires, and any onboarding fee, before you commit to anything. Or request a sample report to see the deliverable first.
"Full-service" means the provider investigates potential matches for you, rather than handing your team a list of maybes to resolve. Here is how CFVA compares to the established full-service providers. Competitor figures are drawn from an independent 2025 secret-shopper evaluation for an organization screening roughly 2,000 records; rates and terms may have changed since — always confirm current pricing with each provider.
| CFVA Screening | Exclusion Screening | Verify Comply | ProviderTrust | Streamline Verify | |
|---|---|---|---|---|---|
| Monthly price | $310 flat | $460 | $602 | ~$1,300 | $3,500 |
| Setup / onboarding fee | None (Base) | $200 | $2,640 | $1,500 | None |
| Contract required | None — month to month | 1-year term | 1-year term | 1-year + 5% annual escalator | 1-year contract |
| Full-service investigation | Yes | Yes | Yes | Yes | Yes |
| Federal lists (LEIE · SAM · OFAC) | Yes | Yes | Yes | Yes | Yes |
| State Medicaid exclusion lists | Federal + California & a growing set of states | Multi-state | Multi-state | Multi-state | Multi-state |
| Stores your staff's SSNs | Never — by design | Handles identity verification | SSN/EIN/NPI matching | SSN or EIN/TIN matching | Handled at enterprise tier |
| Direct human support | Yes — Sacramento-based | Portal + team | Portal | Portal | Portal |
| Built for | Small & solo practices | All sizes | All sizes | Hospitals / health systems | Enterprise |
Competitor pricing and features reflect a September 2025 independent secret-shopper evaluation and each provider's published materials; figures may have changed — confirm directly. CFVA is the most affordable transparent, no-contract, no-setup full-service option shown. State coverage expands over time; we confirm exactly which lists apply to your practice before you rely on us for them. CFVA never stores Social Security numbers under its Base service.
Tell us a little about your practice and we'll send you a sample report — the real format, the real flags, the exact documentation you'd receive each month. No roster required to see it. When it fits, you subscribe, and the screening begins.
Request a Sample Report