Mitigate Risk: Physician Background Checks

Background checks are within the administrative provisions of the HIPAA security rule. A recent bill proposed in Colorado would mandate both fingerprints and background checks for healthcare professionals. The proposed bill would affect nurses, medical doctors, dentists, dental hygienists, nurses, certified nurse aides, optometrists, physician assistants, podiatrists and veterinarians.

Building on the notion indigenous to HIPAA, a recent article in The Denver Post highlights that security is becoming more of a focus. Specifically, Colorado State Rep. Janet Buckner (D) proposed Colorado House Bill 17-1121, which would require fingerprinting and criminal background checks for healthcare professionals.

Implementing fingerprint-based background checks would bring Colorado in line with most states. Colorado is one of only six states that doesn't require doctors to complete criminal records checks before being licensed and one of five states that doesn't have that requirement for nurses.

The requirement to have workforce security and clearance procedures in place has long been established by the HIPAA security rule and memorialized as an administrative safeguard in 45 CFR § 164.308. Two particular subsections that relate directly to this issue are:

Workforce security: Implement policies and procedures to ensure that all members of a workforce have appropriate access to electronic protected health information, as provided under paragraph (a)(4) of this section, and to prevent those workforce members who do not have access under paragraph (a)(4) of this section from obtaining access to electronic protected health information.

Workforce clearance procedure: Implement procedures to determine that the access of a workforce member to electronic protected health information is appropriate.

These two provisions require employers make sure that employees are given the minimum access necessary to perform their job and that they are qualified to perform the work and have no criminal background. Since most providers accept Medicare and Medicaid, these two items are particularly crucial to abide by.

The bill recently passed both the House Health, Insurance, and Environment Committee and the House Finance Committee and will enter the Senate for consideration. While applicants for medical licenses are already required to provide information on past criminal activity, investigative reports by TheDenver Post last year found that many of those applying to work as doctors and nurses and those already licensed for such work fail to meet the required disclosures.

The bottom line is, an adequate background check on new and current employees should not be overlooked, or physicians and healthcare providers are at risk.