CMS Wants Agency Owners to Ink Their Fingers

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
CMS Wants Agency Owners to Ink Their Fingers

Get out your inkpads and flex those digits — CMS will soon implement fingerprint background checks for home health agencies and suppliers of durable Medicare equipment, prosthetics, orthotics and supplies (DMEPOS).

In MLN Matters Number SE1417, released on April 11, CMS said providers in the high risk category who submit claims to a Medicare Administrative Contractor (MAC) must submit fingerprints for anyone with a 5% or greater ownership interest. All providers determined by enrollment screening to be in the high-risk category also will be subject to background checks. The high level of risk category will be applied to providers and suppliers who are newly enrolling DMEPOS suppliers or home health agencies. It will also be applied to providers and suppliers who have been elevated to the high-risk category in accordance with enrollment screening regulations.

MACs will notify home health and hospice agencies in writing, and the individuals named will have 30 days from the letter date to be fingerprinted. CMS tells owners to contact their MAC immediately if they find errors in their ownership listing.

Assuming the list is correct, the owners should contact the fingerprint-based background check contractor (FBBC) named in the letter, and the FBBC will provide at least three fingerprint locations near the agency’s location. CMS “strongly encourages” owners to provide electronic fingerprints, but it will accept an FD-258 card as well. Fingerprints will be forwarded by the FBBC to the FBI for processing, the FBI will compile a background history and share the results with the FBBC, and the FBBC will review the record and provide a fitness recommendation to CMS.

Note that if someone in your organization with a 5% share or greater submits an application with “false or misleading” information, CMS is authorized to revoke your Medicare billing privileges. CMS asks owners to contact their MACs with any questions they have about the new requirement.

CMS fingerprinting and background checks will be used to detect bad actors who are attempting to enroll in the Medicare program and remove those currently enrolled – a goal that’s hard to argue against.

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