The Centers for Medicare & Medicaid Services (CMS) has begun implementation of fingerprint-based background checks for designated Medicare suppliers and providers. The Affordable Care Act (ACA) required CMS to implement enhanced screening provisions for a “high risk” category of Medicare suppliers and providers. CMS has designated all newly enrolling home health agencies (HHA) and durable medical equipment (DME) suppliers as high risk. CMS will require fingerprints for other providers and suppliers designated as high risk in accordance with CMS enrollment screening regulations.  All persons with a five percent or greater ownership interest in either an HHA or DME will be subject to the fingerprint requirement.

CMS will phase in the fingerprint requirement during 2014. Not all providers in the high risk category will be subject to the fingerprint requirement; Medicare Audit Contractors (MAC) will notify providers and suppliers when the fingerprint requirement is applicable to them.

If the MAC notifies an enrolling entity that its owners are subject to the fingerprint mandate, the owners will have 30 days to be fingerprinted. The MAC will direct the owners to contact the CMS Fingerprint-Based Background Check Contractor (Contractor). The Contractor will direct individuals to one of three locations where they can be fingerprinted.  Individuals will incur all costs associated with fingerprinting.

The Contractor will forward the fingerprints to the Federal Bureau of Investigation (FBI) to complete a background check based on the prints and send the results of the check to the Contractor. The Contractor will provide a fitness recommendation to CMS.

CMS described the fingerprint program in an MLN Matters article that readers can view by using the following link:  here.