The HHS Office of Inspector General maintains a List of Excluded Individuals/Entities (LEIE) — providers banned from participating in federal healthcare programs due to fraud convictions, patient abuse, licensing violations, or other offenses. Being excluded means you cannot bill Medicare or Medicaid. Period.
Yet when we cross-reference the LEIE with the Medicaid spending dataset, we find over $350 million in payments flowing to providers who are — or were — on that list. Some of this spending occurred before the exclusion date. But the scale raises questions about how effectively exclusions are enforced.
Which States Have the Most Excluded Provider Spending?
| State | Excluded Providers | Total Spending |
|---|---|---|
| Arizona | 12 | $98.7M |
| Ohio | 35 | $94.1M |
| Nevada | 54 | $53.6M |
| Kentucky | 15 | $27.9M |
| New York | 52 | $12.8M |
| South Carolina | 4 | $10.8M |
| California | 39 | $10.5M |
| Rhode Island | 2 | $9.4M |
| Connecticut | 15 | $8.6M |
| Florida | 17 | $6.3M |
The distribution is wildly uneven. Arizona has just 12 excluded providers but leads the nation at $98.7 million — almost entirely because of one organization. Ohio's 35 excluded providers span home health, behavioral health, and labs. Nevada's 54 excluded providers (the highest count of any state) are almost entirely behavioral health operations.
Arizona: The New Life Wellness Cluster
Arizona's $98.7 million in excluded provider spending is dominated by two related entities:
| Provider | Exclusion Date | Total Paid | Claims | Beneficiaries |
|---|---|---|---|---|
| New Life Wellness Center, LLC | Nov 2024 | $66.0M | 109,485 | 23,707 |
| New Life Wellness Flagstaff, LLC | Nov 2024 | $14.6M | 41,165 | 2,154 |
| Cactus Wren Community Services | Mar 2025 | $10.3M | 8,613 | 2,430 |
| Apache Health LLC | Oct 2024 | $3.8M | 4,086 | 2,167 |
| Nevada First Choice, LLC | Nov 2024 | $3.7M | 5,958 | 1,542 |
The two New Life Wellness entities were excluded on the same date (November 2024) under exclusion type 1128a1 — mandatory exclusion for conviction of a program-related crime. Together they account for $80.6 million in Medicaid payments. The Flagstaff location serving only 2,154 beneficiaries for $14.6 million works out to roughly $6,800 per beneficiary — an extraordinarily high ratio for a behavioral health provider.
Four of Arizona's six excluded providers are mental/behavioral health operations, all excluded under 1128a1. This concentration in one specialty, one state, with recent exclusion dates suggests a pattern that was being investigated — and is now being acted on.
Ohio: Home Health and Behavioral Health
Ohio has 35 excluded providers totaling $94.1 million — the most excluded providers with significant spending of any state except Nevada. The pattern is different from Arizona: more diverse, more providers, and spanning multiple fraud types.
| Provider | Specialty | Exclusion Date | Total Paid |
|---|---|---|---|
| Riverside Recovery, LLC | Substance Abuse Rehab | Jun 2025 | $28.6M |
| Eye for Change Youth & Family | Counseling Center | Jan 2024 | $20.4M |
| Friendly Care, Inc | Home Health Agency | Dec 2023 | $12.6M |
| Buckeye Health and Research | DME - Prosthetics | Dec 2025 | $10.3M |
| Classic Healthcare Services | Home Health Agency | Apr 2022 | $7.0M |
| Vizion One, Inc | Home Health Agency | May 2024 | $5.5M |
Ohio's excluded provider list reads like a tour of Medicaid fraud categories: substance abuse rehab, youth counseling, home health (three separate agencies), and DME. Riverside Recovery at $28.6 million was excluded under "BRCH SA" — a state action for substance abuse violations. Classic Healthcare Services was excluded in 2022 but shows $7 million in total spending across the dataset period.
Nevada: 54 Excluded Providers
Nevada has the highest count of excluded providers of any state at 54, totaling $53.6 million. For a state with only 7,765 Medicaid providers, that's a remarkably high exclusion rate — nearly 0.7% of all billing providers have been excluded, compared to 0.05% nationally.
Almost every Nevada exclusion is a behavioral health provider under 1128a1 (program-related crime). This suggests either systemic problems in Nevada's behavioral health Medicaid program, aggressive enforcement, or both.
Exclusion Types Explained
The exclusion type codes tell you why a provider was banned:
- 1128a1 — Conviction of program-related crimes (fraud, kickbacks, etc.). This is mandatory exclusion, minimum 5 years. The most common type in our data.
- 1128a3 — Conviction of felony related to healthcare fraud. Mandatory, minimum 5 years.
- 1128b5 — License revocation or suspension. Permissive exclusion.
- 1128b7 — Fraud, kickbacks, or bribes. Permissive exclusion. Appears for lab companies in our data.
- BRCH SA — State action, often substance abuse violations.
What This Means
Some caveats: much of this spending likely occurred before the exclusion date. The dataset covers 2018–2024, and many exclusions are recent (2023–2025). A provider excluded in November 2024 could legitimately have $66 million in cumulative spending from the previous six years.
But the pattern is still significant. These are providers who were ultimately found to have committed crimes or violations serious enough to warrant federal exclusion. Their spending history shows the scale of what was at stake — and what might have been lost — before enforcement caught up.
Every excluded provider mentioned above has a detailed profile on this site showing their full billing history. Click any name to see the complete picture, including the exclusion flag on their profile page.