Fingerprinting FAQs

The federal regulation at 42 CFR 455.410(a) provides that a State Medicaid Agency (SMA) must require all enrolled providers to be screened according to the provisions of Part 455 subpart E.  These provisions require the agency to screen all provider applications for initial enrollment, re-enrollment or revalidation, enrolling a new practice location and/or a new taxonomy based on a categorical risk level of "limited", "moderate", or "high" (42 CFR 455.434).  N.C.G.S 108C-3 further defines providers that are impacted in North Carolina.

 

If a provider or provider categorical risk level is designated as "high" risk, the SMA must conduct the same "high" risk FCBCs for Medicaid purposes.

 

If the provider has completed fingerprint-based background checks with Medicare and can be confirmed in PECOS, that can be accepted in lieu of new fingerprinting.

FCBCs are required for all high categorical risk providers and owners who have a 5% or greater direct or indirect ownership interest.  

In accordance with federal regulation 42 CFR 455.450; the SMA may adjust a provider or supplier's screening level from "Limited" or "Moderate", to "High" if any of the following occur:

 

1. SMA has imposed a payment suspension within the last 10 years;
2. If the provider has been excluded from Medicare by the OIG;
3. If the provider has had billing privileges revoked by CMS within the previous 10 years;
4. If the provider has been excluded from any Federal Health Care Program;
5. If the provider has been subject to any final adverse action, in the previous 10 years;
6. If the provider has been terminated or is otherwise precluded from billing Medicaid; or if SMA lifts a temporary moratorium for a provider or supplier type and a provider or supplier that was prevented from enrolling based on the moratorium, applies for enrollment as a Medicare provider or supplier at any time within 6 months from the date the moratorium was lifted.

Provider risk level indicators are defined on the Provider Permission Matrix under Column N (Risk Level Indicator). The Provider Permission Matrix is available on the NCTracks Provider Enrollment webpage.

The person notified to complete a are required for all high categorical risk providers and owners who have a 5% or greater direct or indirect ownership interest fingerprint-based background check will incur the cost of having their fingerprints taken, which may vary depending on location.

Locations for Fingerprinting services can be found on the NCTracks Fingerprinting FAQ page under Fingerprinting Resources section. Providers are encouraged to call their chosen location and confirm that information listed has not changed.

Fingerprinting results can be accepted from Medicare through PECOS. No other agency or entity’s fingerprint-based background check results can be accepted.

Managing employees are not required to be fingerprinted.

Please click on the link below for more information about the fingerprinting requirement as well as a list of locations.

 

https://www.nctracks.nc.gov/content/public/providers/faq-main-page/faqs-for-fingerprinting.html

No, the results from a fingerprint-based background check cannot be shared between agencies.

The fingerprinting notification will be sent to the Office Administrator's email listed in the NCTracks secure provider portal. 

No, providers should wait to be notified by NCTracks before having their fingerprints taken. A form will be generated by NCTracks with a unique case number. The case number on the form will ensure that the results from the fingerprinting can be matched to the provider application with NCTracks.

 

Fingerprinting done without the form generated by NCTracks, with a unique case number, will not be accepted to satisfy the fingerprinting requirement.

Out of State providers required to submit fingerprints can go to their local Sheriff’s Department.

We encourage live scan results, but if you receive your Fingerprinting card you must mail it to the SBI for processing at NCSBI/Applicant Unit 3320 Garner Road Raleigh, NC 27626. The Electronic Submission Release of Information form is still required to be uploaded to NCTracks.

This section should be completed by the Official at the Sherriff’s Office at the time of fingerprinting.

The form is generated from what was entered in your NCTracks application therefore you should contact CSRA to withdraw the application. The application should then be submitted with the correct information and the form will be re-generated.

No, forms must be electronically uploaded to the provider’s record in NCTracks by using the following steps:

 

1. From the Submitted Applications section of the Status and Management page, the OA will see that any NPI that has a status of “In Review” will also have a hyperlink to Upload Documents.
2. Once Upload Documents is selected, the OA should attach the form and click Submit Now.
3. At this point the process is complete.

Forms mailed to NCTracks or the location under the Agency Section on the Electronic Submission Release of Information form will not be processed. The Electronic Submission Release of Information form MUST be uploaded into NCTracks to the provider record. Failure to meet the stated deadline will result in denial or termination.

Once fingerprinting results are on file at NCTracks, the results are valid for a full five-year period for an individual provider or any person with a 5 percent or greater direct or indirect interest ownership interest in the organization. NC Medicaid will rely on the results from the previous fingerprint submission.