This article explains exclusions, their impact, and provides a link to access a complete list of exclusion sources. An exclusion prevents individuals or entities from participating in federally funded benefit programs due to reasons such as fraud, drug abuse, licensing issues, healthcare-related crimes, or defaulting on federal student loans. Agencies maintain regularly updated exclusion lists and excluded parties cannot receive payments from federal programs. Healthcare organizations making payments to excluded individuals or vendors may face fines or penalties.
What is an Exclusion?
An exclusion occurs when a federal or state agency sanctions, suspends, excludes, or debars an individual or entity from participating in federally funded benefit programs. This can happen for various reasons, including:
- Fraud
- Drug abuse
- Licensing issues
- Healthcare-related misdemeanors or felonies
- Defaulting on federally backed student loans
Currently, 45 states and two federal government agencies maintain exclusion lists. These lists are regularly updated to reflect the most current information.
If an individual or entity is excluded, they are prohibited from receiving direct or indirect payments from federal benefit programs. For healthcare organizations, this means payments cannot be made to an excluded person or vendor without risking fines or penalties.
To review a complete list of all exclusion sources, click here.