Home Health & Hospice Week

National background check contractor is pending.

You might find you have to step up employee background check activities, if Medicare listens to the OIG’s advice.

The HHS Office of Inspector General has released two reports on background checks. One addresses the National Background Check Program for long-term care providers, while the other focuses on Medicaid background check requirements for high-risk providers (including home health agencies).

For the LTC checks, nine of 11 states partic­ipating in the program didn’t implement all program elements because they lacked state legislative authority to do so, the report reveals. The checks that were run racked up 25,000 determinations of ineligi­bility for prospective employees. The OIG urges the Centers for Medicare & Medicaid Services to encourage states to obtain the legislative authority to implement all the program requirements.

For the Medicaid background check report, the OIG found that as of Jan. 1, 13 states still hadn’t implemented fingerprint-based criminal background checks as required by CMS. The OIG also found two loopholes, where states didn’t background check providers if there already were enrolled in Medicare, and where they let providers self-report ownership without outside verification.

The OIG urges CMS to close both those loopholes, but CMS doesn’t agree. Medicare enrollment should be a good enough check, the agency says in its response letter. And it plans to procure a contractor that will conduct fingerprint background checks on all Medicare and Medicaid providers anyway.

For the ownership issue, CMS says it would be too heavy of a burden for states to cross-check their often-paper-based ownership paperwork against Medicare’s electronic files. CMS does offer a service to match electronic records against one another, and states should use it, the response letter says.

CMS agrees to ensure all states comply with the fingerprint-based criminal background check requirement.

See the reports at https://oig.hhs.gov/oei/reports/oei-07-18-00290.pdf and https://oig.hhs.gov/oei/reports/oei-05-18-00070.pdf.