CMS Implements Fingerprinting Background Checks for New DME and Home Health Providers

In a recently released MLN Matters (Number: SE1417), CMS announced that it is implementing the enhanced enrollment screening provisions of the Affordable Care Act (ACA) by requiring finger print based background checks for certain so called “high risk” providers. Currently this means that for newly enrolling Durable Medical Equipment, Prosthetic, Orthotic and Supplies (DMEPOS) suppliers and Home Health Agencies, individuals with a 5% or greater ownership interest in the provider or supplier will be subject to criminal background checks based on fingerprint identification. The procedure will also apply to providers that CMS has elevated to the high risk category pursuant to regulations. Affected providers will be notified by their MAC and be given 30 days to comply. The notification will identify contact information for the Fingerprint Based Background Check Contractor (FBBC).

Fingerprints can be submitted on a form FD 258 or electronically at specified locations. CMS prefers electronic submission as it is faster and more accurate. May states already require criminal background checks based on fingerprints for a host of health and child care providers and there may be multiple locations in a community where individuals can submit fingerprints electronically.

Ultimately the FBI will process the prints and the FBBC will, on behalf of CMS, make a recommendation of fitness to CMS based on the record. Data will be maintained and secured in accordance with the Privacy Act of 1974 and the FBI CJS Security Policy.

For more information on the fingerprinting background check requirements, please contact Martha J. Sweterlitsch or any member of our health care practice group for a further discussion.

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