CMS Phases in Fingerprint-Based Background Checks for DME Suppliers

The Centers for Medicare and Medicaid Services (CMS) will be phasing in fingerprint-based background checks this year for certain providers as a way to slow and prevent rampant fraud. These background checks will initially be applied to those durable medical equipment, prosthetics, orthotics and supplies providers and home health agencies trying to enroll in Medicare and will remove the “fraudsters” already enrolled. In the future, CMS will also apply the fingerprint-based background check requirements to those providers considered to be “high-risk.” These efforts stem from the Affordable Care Act’s provisions to augment Medicare’s enrollment screening.

recent article in Fierce Health Payer Anti-fraud’s online newsletter states:

CMS will send notification letters to affected providers with contact information for the fingerprint-based background check contractor. Providers will be required (generally just once) to pay for and undergo fingerprinting.

The contractor will collect fingerprints and send them to the FBI for processing. Within 24 hours of receipt, the FBI will compile a background history. CMS will assess the data and either approve the provider application or exercise authority to deny the application or revoke Medicare claims filing privileges.

For more information on this new background check requirement, see CMS’ Medicare Learning Network Matters notice: Implementation of Fingerprint-Based Background Checks (pdf).