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In September, the Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) issued a proposed rule establishing procedures under which screening will be conducted for those that provide medical services and/or supplies to the Medicare, Medicaid and SCHIP (Children's Health Insurance Program) programs.  The proposed rule is intended to improve the integrity of these programs, by reducing fraud, waste and abuse.  (The proposed rule will be effective on March 23.) 

While some screening does occur today, the proposed rule would divide providers and suppliers into 3 levels of risk: "limited," "moderate" and "high.”  Those providers and suppliers that are determined to be a high level of risk will require a criminal history background check and the submission of fingerprints.

Criminal background checks will assist CMS and the State (as applicable)in determining if an individual, such as an owner, authorized official, or delegated official, or managing employee of a high-risk provider or supplier type is eligible to provided services associated with any of these programs. 

The use of fingerprinting will further help to verify an individual's identity and to resolve issues associated with identity theft and fraudulent billing. 

Earlier this year, CMS issued a solicitation for Federal matching grants to all States and U.S. Territories for a multi-year National Background Check Program for Patient Protection for direct patient access employees of long term care facilities and providers.  These providers include nursing homes and other entities that provide services through a variety of authorities including Medicaid State Plan services and Medicaid waiver authorities such as home and community based services.  The program is intended to assist all States that desire to institute or upgrade their systems and/or processes for employee background checks. Per the CMS, "The goal of the program is to prohibit the hiring of employees who have histories of abuse or relevant criminal violations from serving the vulnerable long term care population." A second solicitation is expected to be posted yet this year.

How can a program this far-reaching and complex be undertaken successfully? Just ask us:  Daon Trusted Identity Services (DTIS) operates the nation's largest proven and trusted civilian clearinghouse for fingerprint, biometric and biographic processing in support of a number of organizations including the Transportation Security Clearinghouse (TSC) which screens active airport employees.

Leveraging its experience and expertise in creating program specific solutions and providing managed services,  DTIS provides TSC with hosted, network based services for biometric identity management, including enrollment, FBI Criminal History Record Checks, 3rd party background checking, secure biometric and biographic information storage and card issuance/lifecycle management.

Key to the success of the propose CMS rule described above is easy access to enrollment centers and in-depth criminal history background checks.  Daon's nationwide network of fingerprint collection centers along with its secure identity management capabilities that include FBI/national criminal history background checking services combine to form a solution that is unsurpassed in scope and capabilities.  

Learn more about how Daon's solutions and services can be used to reduce or deter fraud and ensure identity protection by reviewing case studies and other details.