Healthcare Compliance · HR Automation · Pulse Software Solutions
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Meet the Client
A large orthopedic and spine healthcare provider (name withheld for confidentiality) operates across multiple locations with dozens of employees and contractors. As a participant in federal healthcare programs, the organization must verify that none of its staff or vendors appear on the OIG List of Excluded Individuals and Entities (LEIE), the federal database of people barred from participating in Medicare, Medicaid, and other federal programs.
Hiring or retaining an excluded individual, even unknowingly, can lead to severe federal penalties and loss of reimbursements. For this client, compliance is not optional, it is existential.
The client needed a reliable, automated exclusion verification process to replace tedious manual checks that no longer scaled with their workforce.
The Challenge
Healthcare organizations are expected to screen all employees, contractors, and vendors against the OIG exclusion list every single month. Failing to do so risks heavy fines (often tens of thousands of dollars per violation) plus loss of Medicare and Medicaid reimbursements for any services provided by an excluded person.
The client’s HR and compliance teams were manually checking the OIG online database periodically, a time-consuming, error-prone task. With over 50 employees and steady growth, the manual process left too much room for human error and potential oversight. They needed an automated solution that could:
Eliminate manual name-by-name searches and run the full roster against the LEIE on a fixed schedule.
Screen every employee and contractor on schedule, plus new hires during onboarding so nobody slips through between cycles.
Generate audit-ready reports each month to demonstrate due diligence in case of a federal review.
Pull data directly from Paylocity (or any major HR platform) without duplicate entry, and handle PII responsibly.
The Solution
Pulse Software Solutions developed a secure, cloud-ready software solution that automates the entire LEIE exclusion verification process. The system is built on a robust tech stack (ASP.Net Core web services with a SQL Server database) and can be deployed on the client’s cloud environment or on-premises servers, depending on their preference.
We designed it with flexibility so the same framework works with any popular HR or payroll platform via APIs. The solution connects to the client’s HR software (in this case, Paylocity) through its API to pull the latest employee roster each month. No manual spreadsheets needed.
Our framework is adaptable to every major HR and payroll platform, Gusto, ADP, Paylocity, BambooHR, QuickBooks Payroll, Paychex, Square Payroll, Rippling, OnPay, and more, by leveraging their published APIs. No matter which platform a healthcare organization uses, our exclusion-check system can plug in securely and retrieve the necessary employee and vendor data automatically.
How It Works
The system runs on a fixed schedule (the 15th of each month, adjustable to any cadence). Each run completes the full workflow end-to-end with no manual intervention required.
The system calls the Paylocity API using stored secure credentials to fetch the updated list of all active employees, contractors, and vendors. Key identifying fields (first name, middle name, last name, date of birth, address) are gathered and stored in a secure staging table. By design, no Social Security Numbers or unnecessary PII are stored in our database.
The system downloads the most recent OIG LEIE exclusion list directly from the official HHS OIG source using a fixed URL for the current CSV. The LEIE updates monthly, so each run pulls fresh data. If the download fails for any reason (network issue, source outage), an alert notification fires to the support team immediately.
The downloaded CSV (containing the excluded individual’s name, DOB, address, exclusion type, and more) is parsed and loaded into the database. Previous months are archived for historical reference, while each new run uses the freshest download for the actual comparison.
The HR roster is compared against the LEIE using multiple algorithms. Exact matches lock onto full name (with light normalization) or last name plus first name plus middle initial, cross-checked against date of birth when available. Fuzzy matches use phonetic algorithms like Soundex to catch “John Smith” versus “Jon Smyth,” plus partial matches on name prefixes combined with matching DOB or ZIP code, flagging possible hits for human review.
A clear report goes out by email to designated recipients (HR director, compliance officer, etc.) showing total records checked, any exact matches, any close matches, and the specific LEIE record details for each flagged person. Even on a clean run with zero matches, an “all clear” email still goes out, providing documented proof the check was performed. Process failures trigger instant alerts. We typically use SendGrid or the client’s preferred email service for reliable delivery.
Key Features
The architecture prioritizes consistency, security, and zero-touch operation, the three things HR and compliance leaders need most from a monitoring system.
The entire process runs on a schedule without manual effort. Human error drops to zero. Nothing gets overlooked, nothing forgotten.
Integrates with Gusto, ADP, Paylocity, BambooHR, and more via API, so the screening always runs on current roster data, not a stale spreadsheet.
Data moves over encrypted channels. No SSNs or unnecessary PII stored. Access is locked to authorized personnel on a HIPAA-aligned environment.
Runs on Azure (VM plus Azure SQL) or on a client’s Windows server. This client chose self-hosted with a lightweight Windows service and scheduler.
Step-level logging and error catching. If the HR API or OIG source is down, the right people are paged within minutes so the run can be retried.
Every deployment ships with a 90-day warranty plus on-demand support and enhancements as the organization grows.
Results & Benefits
The first monthly report screened 58 employees and surfaced a handful of items for review: two exact matches (both confirmed as false positives caused by common names) and two close matches that were cleared after verification. The HR team documented every step, confirmed no actual excluded individual was on staff, and closed the audit trail for that month within hours instead of days.
Client Case Study
HR staff were spending hours each month manually searching the OIG database for 50+ employees, with no consistent paper trail and growing exposure to federal penalties as the practice expanded.
Paylocity API integration pulling the live roster every month
Exact and fuzzy matching engine with phonetic and partial logic
Auto-emailed monthly compliance reports plus failure alerts
On-premise Windows service with scheduled SQL jobs
The required exclusion check now runs every month without fail. Auditors get timestamped reports as evidence on demand.
HR no longer combs through names on the OIG website. The team focuses on flagged cases and higher-value work instead of repetitive lookups.
Catching matches early and regularly cuts the chance of inadvertently employing an excluded individual and facing $10,000-per-incident fines.
If an excluded person were ever identified, alerts let management remove them from federal program duties immediately, protecting billing and reputation.
Every monthly email is a documented record. When regulators ask for proof, the team has a consistent paper trail ready to share.
The same engine screens vendors, contractors, and medical staff, and runs on-demand during onboarding so nobody slips through between cycles.
Conclusion
With Pulse Software Solutions’ exclusion verification software in place, the client achieved a secure, automated compliance process that scales as the organization grows. What was once a significant administrative burden is now handled by a reliable system that keeps their workforce verified against the OIG exclusion list, reduces regulatory risk, and saves valuable time, all without sacrificing security or flexibility.
This is one example of how Pulse Software Solutions brings healthcare organizations up to speed with OIG LEIE exclusion screening. The same framework adapts to any HR or payroll platform, from ADP and Gusto to Paylocity, BambooHR, QuickBooks, Paychex, Rippling, and OnPay.
Our team handles the heavy lifting, from HR API integration to deployment, so you can stay audit-ready every month without touching a spreadsheet.
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