The federal gap, measured: how much of each state's exclusion list never reaches the LEIE
Federal regulation requires screening against the federal databases — the OIG LEIE and SAM.gov — every month (42 CFR 455.436). But states exclude providers for reasons that never propagate to the federal lists: license actions, state program-integrity findings, Medicaid fraud-unit referrals, terminations for cause. Measured across every state list we ingest, about half of active state exclusions do not appear on the federal LEIE — and in some states the share exceeds 90%. Under ACA §6501, an exclusion or for-cause termination in one state's Medicaid program is grounds for termination in every other state, so each row below is exposure a federal-only screen never sees.
The number that matters: a compliance program screening only the LEIE misses ~53% of active state-level exclusion records — tens of thousands of provider exclusions invisible to federal-only screening. Every figure on this page recomputes from the live dataset each day.
The map
Every state, ranked
Share of each state's active exclusions absent from the federal LEIE, largest gap first.
| State | Active exclusions | Not on the LEIE | Gap | Source format |
|---|
How we measure it
Plain-English methodology, no tricks:
- What's being compared. Every currently-active exclusion record from each state's own published list, against the current federal OIG LEIE — both sides from the same daily-refreshed dataset, loaded from the agencies' own publications.
- How a match is decided. A state record counts as "on the LEIE" when it resolves to the same provider on the federal list — NPI-verified matches first (validated against the CMS NPPES registry), then exact-identity matching. Ambiguous records are counted conservatively.
- What the gap is. The percentage of a state's active exclusion records with no corresponding federal LEIE record. It is a measure of visibility, not of wrongdoing: states exclude for state-law reasons the federal process may never adopt.
- What it is not. Not a criticism of any agency — states publish exactly what their mandate requires. The gap exists because the two systems have different scopes; compliance teams simply need to see both.
- Freshness. Sources are re-fetched and the gap recomputed daily; the as-of timestamp above comes from the dataset itself.
Screen against the whole picture in one query: get the dataset on the Snowflake Marketplace (free) — or read the data dictionary and per-source attribution.