New Jersey keeps its own list. 3,991 of the 4,020 people and entities currently excluded there do not appear on the federal LEIE under the same name. If you screen only the federal list, those are the ones you miss.
That is the whole rule, and it is unforgiving. The moment an excluded individual touches a claim — as 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.
The duty to check sits with the provider who bills. OIG guidance is to screen monthly, and to screen everyone whose work can reach a claim — not only the people who hold a licence.
New Jersey maintains the Medicaid Ineligible Provider Report, published by the New Jersey Office of the State Comptroller, Medicaid Fraud Division, separate from the federal OIG LEIE. A provider who is clear on the federal list can still be excluded in New Jersey — and NJ FamilyCare / Medicaid will not pay for services furnished, ordered, or prescribed by them. Screening one list is not screening.
The federal rules apply on top of that, in every state:
Federal Medicaid dollars flow through the states. When a state pays a claim tied to an excluded person, that payment is not eligible for federal matching funds — the state absorbs the loss. That is what pushed enforcement down to the state level: New Jersey maintains its own list and pursues its own recoveries, because federal money is at stake on its books.
NJ OSC Medicaid Ineligible Providers · OIG exclusion authorities · 42 C.F.R. § 455.436
The Medicaid Ineligible Provider Report is published by the New Jersey Office of the State Comptroller, Medicaid Fraud Division. C.F.A.I. holds every record in it and checks it on every screen, alongside the federal OIG LEIE, GSA/SAM, OFAC, and the other state Medicaid exclusion lists we cover.
| Official list | Medicaid Ineligible Provider Report |
| Publishing agency | New Jersey Office of the State Comptroller, Medicaid Fraud Division |
| Current records held | 4,020 |
| Not on the federal LEIE | 3,991 (99.3%) |
| Added in the last 12 months | 49 |
| Records carrying an NPI | 1,183 |
| Date range covered | 20 Aug 1976 – 16 Mar 2026 |
| Source file retrieved | 19 Jul 2026 |
Exclusions added to New Jersey's list, by year:
The figures above describe the source file as retrieved on 19 Jul 2026, not a live query against the New Jersey Office of the State Comptroller, Medicaid Fraud Division. Screening the published list is necessary. It is not sufficient, and no vendor can make it so.
NJ OSC Medicaid Ineligible Providers · Federal LEIE · All C.F.A.I. sources
Send us your employees, contractors, and vendors. We screen every name against the Medicaid Ineligible Provider Report, the federal OIG LEIE, GSA/SAM, OFAC, and the state Medicaid exclusion lists we cover — then we investigate every potential match using NPI, state, and profession to rule out coincidental name collisions, and hand you a resolved, dated report you can put in front of an auditor.
No. New Jersey maintains the Medicaid Ineligible Provider Report, published by the New Jersey Office of the State Comptroller, Medicaid Fraud Division, separate from the federal LEIE. Of the 4,020 records currently on it, 3,991 do not appear on the federal LEIE under the same name. A provider who is clear federally can still be excluded in New Jersey, and NJ FamilyCare / Medicaid will not pay for services furnished, ordered, or prescribed by them.
OIG guidance is monthly, for anyone whose work is furnished, ordered, or prescribed in connection with a federal health care program claim. That includes employees, contractors, and vendors, not only licensed clinicians. 42 C.F.R. 455.436 puts the same monthly cadence on the state Medicaid agency itself. The burden of proving you screened sits with the provider who bills, not with the government.
No federal health care program will pay for it. Under 42 C.F.R. 1001.1901(b) the payment bar covers anything furnished, ordered, or prescribed by an excluded person, and under section 1128A(a)(6) of the Social Security Act civil monetary penalties apply to whoever employed or contracted with them and submitted the claim. It applies per item, and it reaches back over every affected claim, not just the next one.
The Medicaid Ineligible Provider Report, the federal OIG LEIE, GSA/SAM, OFAC, and the other state Medicaid exclusion lists we cover, on every screen. We match on name and, where the source publishes one, on NPI. 1,183 of the records on the New Jersey list carry an NPI.
The figures on this page come from the source file as retrieved on 19 Jul 2026. The oldest exclusion on it dates to 20 Aug 1976 and the most recent to 16 Mar 2026, with 49 added in the last twelve months. We show the retrieval date rather than claiming continuous freshness, because the New Jersey Office of the State Comptroller, Medicaid Fraud Division publishes on its own schedule.
No. A potential match is not a determination that any person or entity is excluded. Name-based matches require human verification, and definitive confirmation requires a Social Security number checked at exclusions.oig.hhs.gov. C.F.A.I. does not collect or store Social Security numbers. Hiring, employment, and contracting decisions remain with you.
Each state runs its own list, on its own statute, with its own definition of who gets excluded. Start with how screening works, or read the state you bill in:
Not sure which lists apply to you? Start with how screening works, or request a screening review.
