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Key federal laws for background checks in the healthcare industry that you need to know

Key federal laws for background checks in the healthcare industry that you need to know

Key federal laws for background checks in the healthcare industry that you need to know

All healthcare organizations are responsible for ensuring that they do not contract with or employ prohibited individuals. Within the United States Department of Health and Human Services, the Office of the Inspector General stipulates that healthcare companies receiving Medicare or Medicaid payments must not hire anyone sanctioned from those programs. The best way to determine if someone is prohibited from working in the healthcare industry is to run a background check.

Federal Laws for Healthcare Background Checks

The Centers for Medicare and Medicaid Services provides funding for states to implement background check programs that are administered by the FBI and DOJ. There are two key laws that state the background check requirements.

Medicare Prescription Drug, Improvement and Modernization Act (MMA)

The MMA, issued in 2003, established a pilot program for background checks. This law covers employees who provide direct patient care. It includes state and federal background checks on all prospective candidates. The pilot program ended in 2007, and it led to the Patient Protection and Affordable Care Act of 2010.

Patient Protection and Affordable Care Act

Within the Patient Protection and Affordable Care Act, the law provides a requirement for long-term care providers and facilities to perform background checks on applicants who would have direct patient access. States determine what direct patient access means and who has it. Compliance is required for facilities and states to continue receiving funding from Medicare and Medicaid. It applies to skilled nursing facilities, home health agencies, hospice, long-term care hospitals, adult daycare centers, residential care centers, assisted living facilities, and nursing facilities.

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