Background Checks and Appeals

Background Checks

What background checks are completed on attendant applicants?
CDCN will complete the following background checks on attendant applicants:

  • Criminal History Record Name Search
    • People convicted of barrier crimes cannot be hired to work in the Virginia Consumer-Directed Services Program. CDCN will request a check of records from the Virginia State Police for the applicant. The police will inform CDCN if the individual has been convicted of a crime and if so, will provide a list of criminal convictions.  
  • List of Excluded Individuals/Entities (LEIE)
    • The US Department of Health and Human Services, Office of Inspector General (HHS-OIG) maintains the LEIE. This list contains names of people with findings of program-related fraud, patient abuse or licensing board actions.
  • Virginia Department of Social Services Central Registry (Child Protective Services)
    • If the Participant is 17 years old or younger, then the Attendant must complete the Virginia DSS Central Registry Check to provide services.

What is a barrier crime?
Virginia laws define barrier crimes as crimes that prevent a person who has been convicted of certain crimes from working with at-risk groups such as children, the elderly, and persons with intellectual disabilities.

Can the Employer hire someone who has been convicted of a barrier crime?
No. If the Criminal History Record Check finds the Attendant has been convicted of a barrier crime, the Attendant cannot receive Medicaid payment to work for you.

What is the LEIE?
The List of Excluded Individuals/Entities (LEIE) is a database maintained by the United States Department of Health and Human Services, Office of Inspector General (HHS-OIG). This database contains names of people who have been convicted of crimes related to Medicare or Medicaid programs, patient abuse, and actions taken by a state licensing authority. These people cannot receive Medicaid funds for payment.

How often will CDCN conduct LEIE background checks?
CDCN will conduct an LEIE background check on all new attendants and on every attendant at least once a month to comply with federal law.

What happens if an Attendant’s name appears on an LEIE background check?
Medicaid payments cannot be made to an excluded person who is named in the LEIE database.

How will I know if an attendant has been excluded from participation in federal health care programs?
CDCN will mail or email you a letter if any attendant is denied employment due to being listed in the federal LEIE database.

What is the Virginia Department of Social Services/Child Protective Services Central Registry?
The DSS Child Protective Services (CPS) Child Abuse and Neglect Central Registry contains information on people who have findings of child abuse or neglect made by a local Department of Social Services office within the Commonwealth of Virginia. The Central Registry Release of Information Form is needed to search the CPS Central Registry.

Can I hire someone who has a finding of child abuse or neglect?
If the Participant is a minor (17 years old or younger) and a CPS Central Registry record check finds that the Attendant has a record of child abuse or neglect, the Attendant cannot receive Medicaid payment to work for you. This Central Registry record check will be performed only if the Participant is a minor.

Appealing Failed Background Checks

Can the finding of a Virginia State Police Criminal History check be appealed?
If an attendant fails a Virginia State Police Criminal History check, he or she must appeal the decision directly with the Virginia Department of State Police.

Manager
Central Criminal Records Exchange
Virginia Department of State Police
P.O. Box 27472
Richmond, VA 23261-7472
www.VSP.Virginia.gov
804-674-2000

Can the finding of a DSS CPS Central Registry search be appealed?
If an Attendant fails a Central Registry search, he or she must appeal the decision directly with the DSS. Information about this procedure is available on the DSS website at www.dss.virginia.gov/appeals/cps.cgi or by calling VDSS at (800) 552-3431 (toll-free) or (804) 726-7000.

Can findings resulting from the LEIE background checks be appealed?
If the Attendant has been excluded by the HHS-OIG due to an LEIE background check, the Participant (or the Employer acting on the Participant’s behalf) has the right to appeal the Attendant’s denial of employment by CDCN with DMAS.

How do I submit an LEIE appeal to VA DMAS?
Appeals concerning LEIE findings can be sent in writing to DMAS by fax or mail:

  • Fax: (804) 452-5454
  • Mail: Appeals Division
    • Virginia Department of Medical Assistance Services
    • 600 E. Broad Street
    • Richmond, VA 23219

Appeals must be received by DMAS within 30 days of the date on the letter from CDCN denying the Attendant’s employment.

Where can I find more information on DMAS appeals?
You can find more information about appeals on the DMAS website at www.dmas.virginia.gov/#/appealsresources.

Where can I find more information about LEIE?
You can find more information about the LEIE database on the HHS-OIG website at www.oig.hhs.gov under “Exclusions Programs.”