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Obtaining Fingerprint Criminal Background Checks for Non-Licensed HCBS Waiver & EPSDT Providers

Mississippisub_regulatoryMississippi Division of Medicaid (Office of the Governor) with Mississippi State Department of Health

What this rule requires your agency to do

  • 1All fingerprint cards and payments must come from the Medicaid facility, not the applicant, and the facility must maintain a copy of each fingerprint card and the Privacy Rights Form.(Obtaining Fingerprint Criminal Background Checks for Non-Licensed HCBS Waiver & EPSDT Providers)
  • 2A clearance letter from another employer dated within the last two (2) years may be used in lieu of a new initial background check, but the renewal check must be completed before the letter expires (2 years from the date of the MSDH notification).(Obtaining Fingerprint Criminal Background Checks for Non-Licensed HCBS Waiver & EPSDT Providers)
  • 3If the background check reveals no disqualifying events, the provider agency is required to issue the applicant a Clearance Letter within two (2) weeks of receiving the results, using the exact "Sample Clearance Letter" language on agency letterhead, signed by the CEO or authorized designee, and notarized; a copy must be placed in the employee's personnel file with a copy of the results.(Obtaining Fingerprint Criminal Background Checks for Non-Licensed HCBS Waiver & EPSDT Providers)
  • 4Providers must pay $50 per applicant background check (covering both state and national checks) online through the Criminal History Fingerprint Payment portal; personal checks, money orders, business checks, and cashier's checks are not accepted.(Obtaining Fingerprint Criminal Background Checks for Non-Licensed HCBS Waiver & EPSDT Providers)
  • 5If results indicate anything other than a clear background check, the provider must request the detailed information from the applicant prior to hiring to validate the events and determine whether they are disqualifying per the Medicaid Administrative Code.(Obtaining Fingerprint Criminal Background Checks for Non-Licensed HCBS Waiver & EPSDT Providers)
  • 6Provider agencies must complete the "Medicaid Facility or Provider Setup Form" and submit it to MSDH to be set up in the Criminal Background Check system before submitting any background check requests.(Obtaining Fingerprint Criminal Background Checks for Non-Licensed HCBS Waiver & EPSDT Providers)
  • 7The applicant must read, sign and date the "Non-Criminal Justice Applicant's Privacy Rights Form," which must be kept in the employee/student personnel file.(Obtaining Fingerprint Criminal Background Checks for Non-Licensed HCBS Waiver & EPSDT Providers)

Applies to: personal care

Instructs non-licensed HCBS waiver and personal care provider agencies on the process for obtaining mandatory fingerprint-based national criminal background checks through MSDH and issuing clearance letters to applicants.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.