Failure to Provide Items or Services
2026 data Public-data reference. official source

Failure to Provide Items or Services

Open-data reference.

Failed to provide medically necessary items or services when obligated under federal health care programs.

77
excluded individuals/entities
77
Total Exclusions
0.6%
Share of All Exclusions
21
States Affected
California
Highest Count State

Recent Exclusions

Name State Category Date
LLOYD ALAN COSTELLO CA Physician 2024-01-19
JASON ADAM DREYER WA Physician 2023-04-20
149 BALLSTON AVENUE, LLC NY Other Business 2023-02-27
BALLSTON TWO, LLC NY Other Business 2023-02-27
SARATOGA CARE AND REHABILITATI NJ Other Business 2023-02-27
SARATOGA CENTER FOR CARE, LLC NY Other Business 2023-02-27
JACK JAFFA NY Business Owner/Executive 2023-02-27
ALLEN JAY SCHWARTZ NY Business Owner/Executive 2023-02-27
JEFFREY JR VEGH NY Business Owner/Executive 2023-02-27
LEON MELOHN NY Business Owner/Executive 2023-02-24
RICHARD IRA MINTZ PA Physician 2019-07-18
JOSEPH P GALICHIA KS Physician 2019-05-07
CINDY JUNE SCOTT TN Licensed Healthcare Professional 2018-09-14
STEPHEN FREDERICK LATMAN PA Physician 2018-03-26
DESERET HEALTH GROUP, LLC UT Other Business 2017-01-06

Failure to Provide Items or Services by State

Actual exclusion counts from HHS OIG LEIE database by state.

Source: HHS Office of Inspector General — List of Excluded Individuals/Entities (LEIE) HHS Office of Inspector General — List of Excluded Individuals/Entities (LEIE)

What the Failure to Provide Items or Services Numbers Reveal

The failure to provide items or services category currently accounts for 77 federal healthcare exclusions — roughly 0.6% of all active OIG LEIE entries. Exclusions under this category span 21 U.S. states, meaning licensing discipline in this specific action type is not concentrated in a single jurisdiction. California records the highest concentration with 16 excluded providers, while New York follows with 16. Because this data comes directly from the HHS Office of Inspector General's monthly LEIE file, every entry reflects a formal federal debarment — not a pending allegation.

Failed to provide medically necessary items or services when obligated under federal health care programs. Patterns like this matter because healthcare organizations are legally required to screen employees, contractors, and referring providers against the LEIE before hiring and on an ongoing basis. A single billing interaction involving an excluded provider under the failure to provide items or services category can trigger civil monetary penalties of up to $100,000 per item or service furnished, plus treble damages. The 77 individuals and entities currently flagged represent an active compliance exposure for every hospital, clinic, pharmacy, and insurer operating in the affected states.

For patients and families, the state-by-state breakdown above is a starting point for verification — not a substitute for it. Exclusion status can change monthly as providers are added, reinstated, or moved between action categories. Before choosing a provider, always cross-check the current OIG LEIE at oig.hhs.gov and the relevant state medical board's public license verification tool. Because failure to provide items or services exclusions carry federal weight, they typically persist across state lines even if a provider relocates, making the LEIE the single most official source for confirming eligibility to receive Medicare, Medicaid, or TRICARE payments.

Frequently Asked Questions

What is a failure to provide items or services exclusion?

Failure to Provide Items or Services is a type of exclusion action taken by the HHS Office of Inspector General (OIG) under federal law. When a healthcare provider receives this exclusion, they are barred from participating in Medicare, Medicaid, and all other federal healthcare programs. There are currently 77 failure to provide items or services exclusions across all U.S. states. Failed to provide medically necessary items or services when obligated under federal health care programs.

What is the impact on healthcare providers?

When a provider is excluded under the failure to provide items or services category, no federal healthcare program will pay for any items or services furnished, ordered, or prescribed by the excluded individual or entity. Healthcare organizations that employ or contract with excluded providers may face civil monetary penalties of up to $100,000 per item or service. Exclusions also affect the provider's ability to work in most healthcare settings, even in non-billing roles, since organizations risk penalties for any involvement of excluded individuals in federally funded care.

How can I check if a provider is excluded?

To check if a specific provider has been excluded, search the OIG's List of Excluded Individuals/Entities (LEIE) database at oig.hhs.gov. You can search by name, specialty, or state. The database is updated monthly and includes all currently excluded providers. Healthcare organizations are required to check the LEIE before hiring and on a regular basis (typically monthly) to ensure no current employees or contractors are excluded. The System for Award Management (SAM) exclusion database also contains exclusion records.

Can a provider be reinstated after exclusion?

Providers excluded under the failure to provide items or services category may apply for reinstatement after the minimum exclusion period has elapsed. The minimum period varies by exclusion type — mandatory exclusions under Section 1128(a) of the Social Security Act typically carry a minimum 5-year period, while permissive exclusions under Section 1128(b) can vary. The provider must submit a written request to the OIG and demonstrate that the circumstances that led to exclusion have been resolved. Reinstatement is not automatic and requires OIG approval.

Related

Data sourced from official federal and state medical-board disciplinary records (FSMB, state boards). See our methodology for details. Retrieved and formatted by PlainDiscipline Editorial

Disclaimer: This information is provided for informational purposes only and does not constitute professional advice. Data is sourced from the HHS Office of Inspector General (OIG) and BLS. Consult a qualified professional before making decisions based on this data.

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