Understanding Federal Laws for Background Checks in Healthcare: A Guide for Employers and HR Professionals

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Background checks play a crucial role in maintaining the integrity and safety of healthcare organizations. As an employer or HR professional in the healthcare industry, it's essential to understand the federal laws governing background checks to ensure compliance and protect your organization's reputation. It’s imperative to remain educated about key legislation and best practices for conducting background checks in healthcare to ensure a safe working environment.

Federal Laws  

The Medicare-Medicaid Anti-Fraud and Abuse Amendments (MMA) 

The MMA was enacted to combat fraud and abuse within federal healthcare programs. One of its main provisions requires the Department of Health and Human Services (HHS) to exclude individuals and entities convicted of certain offenses from participating in Medicare, Medicaid, and other federal healthcare programs.

As a healthcare employer or HR professional, it's essential to understand the implications of the MMA. Conducting thorough background checks on potential employees helps you avoid hiring individuals who may be excluded from federal healthcare programs due to previous convictions.

The Patient Protection and Affordable Care Act (PPACA) 

The PPACA, commonly known as Obamacare, introduced several provisions related to background checks in healthcare. One such provision is the Nationwide Program for National and State Background Checks for Direct Patient Access Employees of Long-Term Care Facilities and Providers. This program aims to improve the quality and safety of long-term care services by establishing a comprehensive background check system for employees.

To implement the program, the U.S. Department of Health and Human Services (HHS) collaborates with state authorities, creating a partnership to ensure a more effective and efficient background check process. As an employer in the healthcare industry, it's crucial to familiarize yourself with the requirements of the PPACA and how they may impact your organization's hiring processes.

Types of Background Checks in Healthcare 

In addition to understanding federal laws, healthcare employers and HR professionals need to be aware of the various types of background checks commonly conducted in the industry:

  • Criminal background checks: These checks include federal, state, and local records to identify any criminal history that may be relevant to the applicant's potential job responsibilities.
  • National Practitioner Data Bank (NPDB) and Healthcare Integrity and Protection Data Bank (HIPDB) checks: These databases collect information on healthcare practitioners' licensure, disciplinary actions, malpractice payments, and more. Accessing this information can help you make more informed hiring decisions.
  • Employment history, education, and licensure verification: Confirming an applicant's work history, education, and professional licenses is essential to ensure they possess the necessary qualifications and experience for the position.
  • Drug testing: Substance abuse screening may be required or recommended for certain healthcare positions, particularly those involving direct patient care.


Best Practices for Healthcare Employers and HR Professionals 

To maintain compliance with federal and state regulations and protect your organization's reputation, consider the following best practices:

  • Develop a compliant background check policy that aligns with federal and state laws.
  • Stay up-to-date on changes to background check laws and regulations to ensure your organization's policies remain compliant.
  • Work with a reputable background check provider that understands the unique needs of the healthcare industry and can help you navigate the complexities of compliance.
  • Apply your background check policy fairly and consistently to all applicants, ensuring an unbiased and equitable hiring process.

How Can DISA Help?  

Understanding the federal laws governing background checks in healthcare is crucial for employers and HR professionals to maintain compliance and protect their organizations. DISA can help you stay informed and proactive to ensure your hiring processes meet legal requirements and contribute to the overall safety and integrity of your healthcare organization. Our background specialists offer professional assistance, while helping you build an employee screening program that fits the needs of your company.


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About DISA Global Solutions 

Founded in 1986, DISA is the industry-leading provider of employee screening and compliance services. Headquartered in Houston, with more than 35 offices throughout the U.S. and Canada, DISA’s comprehensive scope of services includes drug and alcohol testing, background screening, occupational health, and transportation compliance. DISA assists employers in making informed staffing decisions while building a culture of safety in their workplace.

DISA Global Solutions aims to provide accurate and informative content for educational purposes only and does not constitute legal advice. The reader retains full responsibility for the use of the information contained herein. Always consult with a professional or legal expert.