NEMT OIG LEIE and SAM Exclusion Screening Log

This template is for non-emergency medical transportation operators that need to document exclusion screening for drivers, dispatchers, escorts, and other covered staff. It is especially useful for compliance, HR, and operations teams that need one monthly record showing who was screened and when. If your organization bills Medicaid, Medicare, or other healthcare programs, this log helps support exclusion-control expectations. It is not a general employee attendance log; it is a compliance record for screening evidence.

This template is built around a monthly screening cycle, which is the common cadence used to show ongoing monitoring. It also captures pre-hire screening before a person starts covered duties, so you can document both onboarding and recurring checks. If your policy or payer contract requires a different interval, you can adjust the log to match that requirement. The key is consistency and proof that the cycle was completed on time.

OIG LEIE screening checks the Office of Inspector General’s List of Excluded Individuals and Entities, while SAM.gov screening checks the federal exclusion records maintained in the System for Award Management. Many NEMT compliance programs use both because they address different exclusion sources and help reduce the risk of using an excluded individual or vendor. This template keeps the two checks separate so you can document each search date, method, and result. That separation also makes it easier to resolve a potential match without losing the audit trail.

A covered individual is anyone your policy requires to be screened before performing NEMT-related work, such as drivers, attendants, dispatch staff, or contractors who interact with transportation services. The exact roster should follow your internal SOP, payer rules, and any contract language that defines who must be checked. This template includes a screening population field so you can state the scope clearly for each month. If your organization screens vendors or owner-operators, you can add them to the roster as well.

Document the potential match, the identifier details used to verify identity, and the resolution outcome. Do not leave the record as a simple yes/no without follow-up notes, because unresolved matches are a common audit deficiency. If the person is confirmed as excluded, record the corrective action, remove them from covered duties immediately, and note the follow-up due date. If the match is false, keep the evidence that shows how the identity was distinguished.

It creates a month-by-month trail showing the screening population, the search dates, the search method, and the sign-off by authorized staff. Auditors often look for proof that new hires were screened before start date, that monthly re-screening was maintained, and that any exceptions were handled promptly. This log also helps show that inactive or terminated staff were removed from the active roster, which prevents false compliance gaps. In practice, it turns scattered screenshots and emails into one reviewable record.

Yes. You can add fields for employee ID, department, contractor status, screening tool used, or links to saved search screenshots if your workflow requires them. You can also adapt the sign-off section to match your compliance owner, HR reviewer, or operations manager. If you use an HRIS, spreadsheet, or compliance platform, this template can serve as the source record that feeds your broader monitoring process. Keep the core evidence fields intact so the log still proves who was screened, when, and by whom.

The most common issues are missing screening dates, unclear search methods, and rosters that still include terminated staff. Another frequent problem is screening after a person has already started covered duties, which weakens the pre-hire control. Teams also sometimes record only that a search was done, without documenting how a potential match was resolved. This template is designed to capture those details before they become a deficiency.