OIG: 10 States Don’t Require Background Checks for Home Health Workers

Vetting home health care workers—via background checks or fingerprinting—has been an area of consideration for federal regulators in recent months, but a new report reveals not all states have practices in place to screen these employees. 

Of the 50 states and the District of Columbia, only 41 states require home health agencies to conduct background checks of their prospective employees, according to recent findings from the Office of the Inspector General (OIG). 

Meanwhile, of the 10 states that do not have requirements for background checks, OIG found that four states have no plans to implement any such requirements in the future. 


Of the 41 states that do have screening procedures in place, 15 of them require home health agencies to receive the results of background checks before individuals can begin employment and 26 states allow individuals to work while the results of their checks are pending. 

In 15 states, home health agencies require additional background checks of employees subsequent to the initial screening.

Individuals who have certain convictions can be disqualified from potential employment in 35 states, while 16 states allow an individual who has been disqualified from employment to submit an application to have his or her conviction waived. 


While there are no federal laws or regulations that require home health agencies to conduct background checks of their employees prior to hiring, implementing such procedures are critical to the Medicare program, suggests OIG.

In 2012, home health agencies provided services to approximately 3.5 million Medicare beneficiaries, averaging 34 visits per beneficiary, according to data cited in the OIG report. During that year, Medicare paid nearly $18.5 billion for home health services.

In an industry where fraudulent and aberrant billing practices have tallied millions of dollars erroneously billed to federal programs like Medicare, states such as Pennsylvania have already taken initiative into screening prospective employees. 

The Centers for Medicare & Medicaid Services has also been moving forward with plans to implement a long-heralded fingerprint-based background check vetting system for home health care providers.  

View the OIG report.

Written by Jason Oliva

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