Background Checks

Beginning on August 1st this year, providers of health services considered to be at “high risk” for defrauding state Medicaid programs will have to undergo a background check that will include fingerprinting, according to an online story written by Virgil Dickson in Modern Healthcare.

Dickson writes that, in 2014, Medicaid provided medical services to about 60 million people at a cost of $310 billion, but during that same year it is estimated that the rate of improper payments was 6.7% or $17.5 billion dollars.

The individual states will be allowed to determine which health providers are “high risk.”  Once that determination is made, the high risk providers will be required to undergo background and fingerprint checks.

With so much taxpayer money involved, one would have thought that all Medicaid providers would have been required to undergo at least a criminal history background check.  What’s really surprising is that, when the Affordable Care Act was being written, it didn’t include a requirement that all Medicaid providers undergo a background check.  The temptation to defraud the government just seems too great not to have put some screening mechanism in place to reduce the likelihood of fraud!

Better late than never, I suppose.