OIG LEIE excluded providers in NDH
Active OIG List of Excluded Individuals/Entities (LEIE) NPIs that also appear in the federal NDH bulk export. Direct measurement of 42 CFR § 455.436 federal database alignment between the federal directory and the federal exclusion list.
Headline
8,586 of 8,767 actively-excluded LEIE NPIs (97.94%) appear in the 2026-05-08 NDH bulk export — 8,191 as Practitioner resources, 1,064 as Organization resources (9,255 total NDH appearances; some excluded individuals are listed as both a Practitioner and an Organization). Each match warrants immediate state Medicaid revalidation under 42 CFR § 455.436.
9.3K / 8.8K = 105.57%
unit: count
What this means
Regulators
42 CFR § 455.436 requires monthly LEIE checks. If matches exist between active LEIE and NDH, that is direct evidence of federal-level data lag between OIG enforcement and CMS directory publication. The NDH update cadence may need a tighter coupling to LEIE supplements.
Provider data teams
If your practitioner or organization NPI appears here, that is a serious flag. The LEIE search portal at exclusions.oig.hhs.gov is the authoritative source — verify there first, then contact OIG's Exclusion Review Section if you believe the match is in error.
Payer data teams
Each match is a high-priority revalidation case for the state's PI team. AINPI surfaces the cohort; investigation, hearing rights, and any reinstatement claim belong to the state agency and OIG, not to AINPI.
Researchers
The 89% of LEIE rows without a populated NPI are a structural limit on NPI-only matching. State MMIS systems use (lastname, firstname, DOB) demographic match for the remainder. AINPI does not implement demographic match because the data-quality risk on a national directory is too high.
Null hypothesis
Zero NPIs on the active OIG LEIE also appear in the federal NDH bulk export. Federal directory and federal exclusion list are in agreement.
Denominator
Active LEIE rows with a populated NPI (NPI != "0000000000" and REINDATE = "00000000"). Approximately 8,977 of the 83,001 LEIE rows on 2026-04-29; the remaining 89% are predominantly pre-NPI-era exclusions and are out of scope for AINPI's NPI-keyed match.
Data source
OIG LEIE downloadable CSV (`UPDATED.csv` from oig.hhs.gov/exclusions/downloadables) joined to NDH `practitioner._npi` and `organization._npi`. Refreshed weekly via the GitHub Actions cron.
Notes
LEIE source: oig.hhs.gov/exclusions/downloadables/UPDATED.csv. Total LEIE rows: 83,665; with real NPI: 8,767 (10.5%); still actively excluded: 8,767. The 89% of LEIE rows without a populated NPI (pre-NPI-era exclusions) require demographic match logic in the state MMIS — out of scope for AINPI's NPI-keyed methodology. Each match here is a data-quality flag, not a fraud determination — investigation, hearing rights, and reinstatement claims belong to the state PI unit and the OIG. The LEIE search portal at exclusions.oig.hhs.gov is the authoritative source for any individual verification.
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