The scale of US healthcare exclusions

The federal government publishes a list of excluded individuals and entities whose items or services are not payable by federal healthcare programs. The analyzed 2026 snapshot contained 83,665 active exclusion records. The source changes monthly; the counts below describe that snapshot, not a live counter. No names are reproduced here.

An exclusion generally means federal healthcare programs will not pay for items or services furnished, ordered, or prescribed by the excluded party. Reinstatement requires affirmative OIG action; it is not automatic when an exclusion period ends. In this snapshot, 80,233 records were individuals and 3,432 were businesses or facilities.

Where the excluded providers are

Exclusions cluster in the biggest states, but not purely by population — California and Florida together account for nearly a quarter of the entire national list.

Who gets excluded

One role dominates everything else. Nurses and nurse aides make up 34,663 exclusions — more than four in ten — dwarfing every physician, pharmacist, and business category combined.

The skew is structural: nursing and aide roles are the largest health workforce in the country and are licensed by every state, so a state license action flows straight onto the federal list.

Why they were excluded

Each exclusion carries a statutory code from Section 1128 of the Social Security Act. Two authorities account for more than 70% of the entire list — a lost license, or a program-related criminal conviction.

• 1128(b)(4)33,293 · 40%
  License revocation, suspension, or surrender. The single largest reason — a state pulls a provider's license and the federal exclusion follows automatically.
• 1128(a)(1)25,921 · 31%
  Conviction of a program-related crime — fraud or theft against Medicare or Medicaid. A mandatory exclusion of at least 5 years.
• 1128(a)(2)8,084 · 10%
  Conviction relating to patient abuse or neglect. Also a mandatory minimum 5-year exclusion.
• 1128(a)(3)5,851 · 7%
  Felony conviction relating to health care fraud in any health program, public or private.
• 1128(a)(4)3,576 · 4%
  Felony conviction relating to a controlled substance — unlawful manufacture, distribution, prescription, or dispensing.
• 1128(b)(14)2,166 · 3%
  Default on a federal health-education loan or scholarship obligation. Excluded until the debt is resolved.

Exclusions added each year

The list is not shrinking. Federal enforcement adds roughly 2,000–3,000 exclusions in a typical year, with no sign of slowing.

* 2026 is a partial year (data pulled mid-year). Counts reflect the year an exclusion was added for providers who are still excluded today; reinstated providers drop off the list, which lightly deflates older years.

Want to screen against this list?

Credentialing a provider, governing a vendor network, or building a compliance integration? OIG recommends routine screening, while program-specific sources, cadence, and verification duties vary. The API records the exact LEIE source bytes checked, validates NPI check digits, treats normalized-name results as review candidates, and makes incomplete source checks explicit. It is not a consumer report or an employment-eligibility decision.

Screen against the LEIE exclusion list →