SMD# 15-002 State Medicaid Director Letter Re: Medicaid/CHIP Provider Fingerprint-Based Criminal Background Check

In this guidance issued June 1, 2015, the federal Centers for Medicare & Medicaid Services (CMS) notified state Medicaid directors that they must implement fingerprint-based criminal background checks for clinical professionals, medical supplier organizations, and provider organization owners identified as at "high" risk of being involved in fraud, abuse, or waste. The guidance outlines baseline factors state Medicaid programs and state Children's Health Insurance Plan (CHIP) programs must consider in assigning "low," "medium," or "high" risk status to individual clinical professionals, people with a 5% or more ownership stake in a provider organization, or organizations that supply durable . . .