Background checks: Where’s the value?

It’s all about value, says Jim Ziegra, HCIR credentialing manager for heart pump manufacturer Abiomed, Danver, Mass.


“Background checks are a good example,” says Ziegra, who spoke about the topic at the Vendor Credentialing Summit. “Many [healthcare industry reps] are required to submit to a second and in some cases, a third background check as part of the credentialing process. We consider this superfluous and have to ask the question, ‘Does an additional background check add incremental value?’ If not, then eliminate it.”


Background checks are the cause of much discussion – and disagreement – among vendors and providers, says Ziegra. “One of the problems with defining a background check is a lack of consistent terminology and understanding, specifically, what the different types of searches will produce and how they are conducted. Also, keep in mind not all illegal or improper behaviors end up in a criminal court.”


After many hours of discussion among all stakeholders, the Coalition for Best Practices in Healthcare Industry Representative (HCIR) Requirements arrived at six essential “best practice” elements for an HCIR background check:

  • Social security number trace/validation: Confirms year and state of issue along with names and addresses associated with SSN.
  • Criminal records check: Five-year county, state, and federal criminal (felony and misdemeanor) background check – resident states only.
  • National criminal database records check: Database check of available criminal records indexes.
  • National sex offender public registry check: National database of registered sex offenders maintained by the U.S. Department of Justice.
  • Healthcare sanctions search (HHS/OIG/GSA/FDA/OFAC list match): Identifies individuals listed by the government as excluded from participation in Medicare, Medicaid and other federal healthcare programs.
  • Five-panel drug screening: Tests for drugs or controlled substances which are: 1) not legally obtained, or 2) legally obtained, but not used in a lawful manner.


Ziegra says employers of sales reps are in the best position to ensure that their reps meet all credentialing requirements. What’s more, employers have the legal right to ensure compliance. “Employers should be solely responsible for conducting HCIR background checks, retaining the results, and certifying same to healthcare providers,” he says.


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