Medicare Exclusion Database

Richard P. Kusserow | December 2013

The Centers for Medicare & Medicaid Services (CMS) has implemented a Medicare Exclusion Database (MED). It is an online application that provides the ability to download the monthly provider sanctions/reinstatements files, perform an inquiry on the excluded providers, and perform a monthly matching process and administration. The MED includes the entire HHS Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE), along with some other data. Many providers who learn of the MED become concerned and have raised the following questions:

  • Does this new MED replace screening against the LEIE?
  • Does the MED get updated monthly and is it “real-time” consistent with LEIE?
  • Does the MED mean that providers must add it to the list of sanction databases for screening?
  • How do providers/suppliers coordinate checking of the LEIE and the MED?

Well, the answer to all these questions is simple. Providers don’t need to worry about this. Only those who are federal contractors to CMS are authorized access to the MED; and the MED is not accessible to the public, including the health care provider community. The information is only available to those with “IACS IDs” – that is, “Individuals Authorized Access to the CMS Computer Services.” The CMS credential/access system for the IACS requires potential users to register for different roles/systems and needs approval by CMS personnel. Users must enter their account numbers and failure to do so will result in a rejected application.

About the Author

Richard P. Kusserow established Strategic Management Services, LLC, after retiring from being the DHHS Inspector General, and has assisted over 2,000 health care organizations and entities in developing, implementing and assessing compliance programs.