Misdemeanor: Federal or State Program Fraud
2026 data Public-data reference. official source

Misdemeanor: Federal or State Program Fraud

Open-data reference.

Convicted of fraud or false claims in any federal or state program.

331
excluded individuals/entities
331
Total Exclusions
2.4%
Share of All Exclusions
37
States Affected
Pennsylvania
Highest Count State

Recent Exclusions

Name State Category Date
LISA MARIE TRAHAN AZ Licensed Healthcare Professional 2025-11-20
KORI BETH BABB IN Licensed Healthcare Professional 2025-10-20
TANYA LYNN JORDAN IA Licensed Healthcare Professional 2025-07-20
RANDALL JAMES NOVAK NJ Licensed Healthcare Professional 2025-07-20
TREVEN JOSEPH SMITH UT Licensed Healthcare Professional 2025-07-20
STEPHANIE DAWN BEVERIDGE IA Licensed Healthcare Professional 2025-06-19
JESSICA LYNN HALLAM IN Licensed Healthcare Professional 2025-05-20
ANDREA NICOLE RAFFIELD IA Licensed Healthcare Professional 2025-01-20
ANGELO RANDAZZO PA Licensed Healthcare Professional 2025-01-20
ALLISON BRADLEY SOMMERS AZ Licensed Healthcare Professional 2025-01-20
SHARON MARIE WILLIAMS IA Licensed Healthcare Professional 2025-01-20
DAVID JAMES SMITH NV Physician 2024-12-19
DIANA BROOKE TAYLOR IN Licensed Healthcare Professional 2024-09-19
BERNIE MICHAEL SIMONS PA Physician 2024-08-20
AMBER MARIE THOMAS AZ Licensed Healthcare Professional 2024-07-18

Misdemeanor: Federal or State Program Fraud 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 Misdemeanor: Federal or State Program Fraud Numbers Reveal

The misdemeanor: federal or state program fraud category currently accounts for 331 federal healthcare exclusions — roughly 2.4% of all active OIG LEIE entries. Exclusions under this category span 37 U.S. states, meaning licensing discipline in this specific action type is not concentrated in a single jurisdiction. Pennsylvania records the highest concentration with 59 excluded providers, while Michigan follows with 38. 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.

Convicted of fraud or false claims in any federal or state program. 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 misdemeanor: federal or state program fraud category can trigger civil monetary penalties of up to $100,000 per item or service furnished, plus treble damages. The 331 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 misdemeanor: federal or state program fraud 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 misdemeanor: federal or state program fraud exclusion?

Misdemeanor: Federal or State Program Fraud 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 331 misdemeanor: federal or state program fraud exclusions across all U.S. states. Convicted of fraud or false claims in any federal or state program.

What is the impact on healthcare providers?

When a provider is excluded under the misdemeanor: federal or state program fraud 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 misdemeanor: federal or state program fraud 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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