Background checks for NEMT drivers: which searches to run and how to stay FCRA compliant
A complete NEMT driver screen covers county courts for every recent address, the statewide repository, federal courts, the national sex offender website, a motor vehicle record, and the OIG, SAM, and state Medicaid exclusion lists. When a screening company runs it, the FCRA requires a standalone disclosure, the driver's signed consent, and notices before and after any rejection. Rescreen at least yearly and check exclusions monthly.
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What federal law and your broker require
The federal Medicaid statute sets only minimum standards for drivers, and brokers and states build the real screen on top of them. Each state plan must have some way to confirm, possibly just a signed attestation, four things about each paid NEMT company and each individual driver, public transit authorities excepted (42 U.S.C. 1396a(a)(87)):
- No one involved, the company or any driver, appears on the HHS Inspector General’s exclusion list or is otherwise shut out of federal health care programs.
- Every driver carries a license that is currently valid.
- A process exists at the company for addressing state drug law violations.
- The company has a set way to tell the state Medicaid program about each driver’s record behind the wheel, traffic tickets included.
Fingerprinting is a separate federal rule aimed at providers and their owners rather than drivers. Under 42 CFR 455.434, a state must require providers to consent to criminal background checks, including fingerprinting where state law or the provider’s risk level calls for it. When a state places a provider in its high-risk category, the provider and every person owning 5 percent or more, directly or indirectly, must submit fingerprints. See provider risk levels for how states assign them.
Broker contracts and state program rules decide what you actually run on each driver. Two examples show the range.
| Requirement | MTM standard agreement (Pennsylvania version, January 1, 2023) | Virginia FFS NEMT requirements (May 26, 2026 version) |
|---|---|---|
| Criminal search | Five parts, each with an equivalent allowed: county court searches for every former address and alias, a trace of the Social Security number, a national criminal record search, a national criminal database search, and FBI and federal checks | Virginia State Police and/or national databases |
| Sex offender registry | Not listed separately | Included in the required check |
| Timing | Before hire and every year after | Before the driver carries any member; credentialing review at least yearly |
| Driving record | Three years of driving history, pulled annually | A three-year limit of two chargeable accidents or moving violations combined; a point balance no lower than -2; a five-year bar after any license suspension or revocation for moving violations |
| Exclusion lists | No driver on the OIG list, the federal Excluded Parties List System, or similar government lists | Required by federal law |
| Drug and alcohol testing | Pre-employment, post-accident, for-cause, and random | Drivers known to abuse alcohol or drugs may not be used |
Both documents also set disqualifying offenses and lookback periods, and those decide who you can hire once the results are in. The guide to hiring drivers with a criminal record covers them. The driver requirements guide covers licensing, age, and training.
The searches in a complete screen
A complete screen combines several searches, because no single source holds every record. The CFPB counts more than 13,000 state courts of record plus 94 federal district courts, and each jurisdiction keeps and releases records its own way.
| Search | What it turns up | Source | Watch for |
|---|---|---|---|
| Social Security number trace | Past addresses and names used | The screening company | Not a criminal search; it tells you which counties to search |
| County criminal court search | Felony and misdemeanor cases filed in that county | The county court, searched in person or online | Covers only the counties you order, so order every county in the address history |
| Statewide criminal repository | Arrests and dispositions reported to the state | The state police or state records agency | A 2016 survey cited by the CFPB found only 68 percent of arrests in state databases, on average, had final dispositions reported |
| National criminal database | Records compiled from many courts, corrections agencies, and repositories | The screening company’s private database | Update practices vary, and expunged or sealed records can linger; confirm every hit at the court |
| Federal court search | Federal criminal cases, such as fraud and drug trafficking | PACER, the federal courts’ public access system | The CFPB notes these are typically missing from private national databases |
| FBI fingerprint check | Arrests and dispositions in the FBI’s fingerprint-based records | Submitted under a state statute or federal law that authorizes it for the job (28 CFR 20.33) | Not available to employers without that legal authority |
| Sex offender registry | Registered offenders | The Dru Sjodin National Sex Offender Public Website, which links state, territorial, and tribal registries | Confirm any match on the jurisdiction’s own registry |
| Motor vehicle record | License status, violations, accidents, points | The state motor vehicle agency, directly or through the screening company | Get records from each licensing state in the period you review |
| Exclusion lists | People banned from federal health care programs or from federal contracts and awards | The OIG exclusion list (LEIE), SAM.gov, and the state Medicaid agency’s own list | Search the full legal name plus any former names, and keep a dated record of every search |
Exclusion screening carries its own penalty. OIG’s rules bar federal health care programs from paying for anything an excluded person furnishes, orders, or prescribes, and hiring someone on the list can bring civil monetary penalties. OIG tells health care employers to screen both new hires and current staff against the list on a routine basis. The OIG exclusion list entry and the motor vehicle record entry go deeper on those two searches.
Drug and alcohol testing is not a background search, but MTM’s agreement, for one, puts the results in the same credential file. A written drug and alcohol policy sets out when you test and the consequences of a positive test. Whether a driver also needs a DOT medical card depends on the vehicle and the kind of service, which the CDL guide explains.
Running the screen through a screening company
When you buy a screen from a consumer reporting agency, each report is a consumer report, and the Fair Credit Reporting Act sets the steps. Follow them in order.
- Give a standalone disclosure. Inform the applicant in writing, before anything is ordered, that a consumer report may be used for decisions about the job. The document must consist only of that disclosure (15 U.S.C. 1681b(b)(2)), and the FTC adds that it may not be folded into the application form.
- Get written authorization. The applicant’s signature can go on the disclosure document. If you plan to rescreen during employment, say so clearly and conspicuously in the same document.
- Certify to the screening company. Before it releases the report, you certify that you gave notice, got permission, followed the FCRA, and will not use the information to discriminate.
- Add the extra notice for interview-based reports. If the company will call references or former employers about character or reputation, that is an investigative consumer report, and you must give written notice that one may be requested, plus a description of its nature and scope if asked.
- Pre-adverse action notice first. If anything in the report may lead you to reject the applicant or pull a current driver, first give the person the report itself along with A Summary of Your Rights Under the Fair Credit Reporting Act, which the screening company should supply (15 U.S.C. 1681b(b)(3)).
- Wait before deciding. The purpose of the pre-adverse notice is to let the person review the report and point out errors. The FTC’s guidance sets no fixed number of days, so pick a waiting period, put it in your written policy, and use it for every applicant.
- Send the adverse action notice. It says the decision was based on the report, lists the screening company’s name, mailing address, and phone number, states that the screening company played no part in the decision and cannot explain why it was made, and explains that the person may challenge the report’s accuracy and ask the company for another copy at no charge within 60 days.
What a report can and cannot include
The FCRA bars screening companies from reporting arrest records, civil suits, and civil judgments once they are more than seven years old (or, if later, once the governing statute of limitations has run), and most other negative items older than seven years, except convictions (15 U.S.C. 1681c). Convictions have no federal time limit. The seven-year limits do not apply when the job’s annual salary equals or may reasonably be expected to equal $75,000.
Accuracy is the second risk. The CFPB reports that records can show an accurate arrest without a later dismissal, and that screening companies differ in how quickly they remove expunged or sealed records. Read each report against the court record before you act on it.
State and local timing rules
Timing rules exist at the state and city level too. California’s Fair Chance Act stops employers with at least five employees from asking about conviction history until after a job offer. Check your state and city before you put a criminal history question on the application. The FTC also notes that some states restrict how employers use consumer reports, usually credit reports. The hiring guide shows where the screen fits in the full hiring sequence.
Rescreening after hire
A clean screen at hire covers one day. Records change, licenses get suspended, and people land on exclusion lists. Set a calendar for each check and follow it.
| Check | Before the first trip | After hire | Why |
|---|---|---|---|
| Exclusion lists (OIG, SAM, state) | Yes | Every month | States must check enrolled providers, their owners, and managing staff against the OIG and SAM lists monthly (42 CFR 455.436); OIG releases list updates monthly |
| Criminal background | Yes | Every year | MTM’s standard agreement requires it before hire and annually |
| Motor vehicle record | Yes | Every year, or continuous monitoring | MTM asks for a three-year record every year; Virginia’s broker must use the state DMV’s driver alert monitoring program |
| Sex offender registry | Yes | With each yearly rescreen | Required in Virginia’s check |
| License validity | Yes | At each renewal, and whenever a record shows a problem | Federal law requires a valid license for every driver |
| Drug and alcohol testing | Pre-employment | After accidents, for cause, and on a random basis | MTM’s standard agreement |
| Full credential review | Yes | At least yearly | Virginia’s rules for the broker’s credentialing |
Continuous monitoring and mid-year checks are consumer reports too when a screening company provides them, so the authorization you collected at hire must say that checks can continue during employment.
Keeping the records audit-ready
Brokers ask for the file, not your word. MTM’s standard agreement requires updated records on every driver and attendant (owners who drive count too) and says the file must be provided to MTM on request. Keep each driver’s signed disclosure and authorization, every report, dated exclusion search results, driving records, any pre-adverse and adverse action notices, and a short note on each decision. The driver file checklist lists the rest, and the broker credentialing guide shows what reviewers look for.
Two federal rules govern how long and how carefully. The EEOC requires employers to keep hiring records, including applications from people who were not hired, for one year from the date the record was made or the personnel action was taken, whichever is later, and longer if a discrimination charge is filed (29 CFR 1602.14). When you no longer need a background report, the FTC says to dispose of it securely: shred, burn, or pulverize paper, and erase electronic files so they cannot be read or rebuilt.
Tracking expirations in HealthRide
HealthRide tracks the expiration date for every driver credential, from the license to training certificates, reminds you ahead of each expiration, and raises a warning when you try to assign a trip to a driver holding an expired credential. Add the yearly background check and driving record as credentials with due dates, and the reminders keep each rescreen on schedule. See fleet and credentials for how it works.
Frequently asked questions
- When is the driver's written consent needed before a screen?
- Any time a background screening company prepares the report. The Fair Credit Reporting Act requires a clear written notice, in a document containing nothing else, that you may get a report to make employment decisions, plus the driver's signed authorization. The authorization can sit on the same page as the disclosure. If you plan to rescreen during employment, say so clearly in that document.
- Is a national criminal database search enough for a NEMT driver?
- No. Private national databases are built from records that courts, corrections agencies, and state repositories make available, and companies differ in how often they update them. The CFPB notes that federal court records are typically not in those databases. Use a database hit or miss as a lead, and confirm it with county court searches for each address in the driver's history. MTM's standard agreement asks for exactly that mix.
- Can a background report show arrests that did not end in a conviction?
- Sometimes. Under the FCRA, screening companies generally may not report arrests older than seven years, except for jobs paying $75,000 or more a year. Newer arrests can appear, and convictions have no federal time limit. The CFPB warns that a record can show an arrest without the later dismissal, so check the court disposition before you rely on it. State laws may restrict arrest records further.
- How often should NEMT drivers be rescreened?
- At least once a year, with exclusion checks every month. MTM's standard agreement calls for a criminal check at hiring and every year after, plus a yearly three-year driving record. State Medicaid agencies must, under federal rules, screen enrolled providers against the OIG and SAM lists monthly, and OIG tells health care employers to check new hires and current staff routinely.
- Does the FCRA apply if I search court websites myself?
- The FCRA notice and consent steps apply to reports bought from companies in the business of compiling background information. If you search public court sites or the sex offender website yourself, those steps do not apply. Anti-discrimination rules still do, whatever the source, and so does the EEOC's one-year record retention rule. State laws may add their own requirements.
- What goes in an adverse action notice?
- Four things. Tell the driver the decision was based on information in the report. Include how to reach the screening company: its name, mailing address, and phone number. State that the screening company played no part in the decision and cannot explain it. Explain that the driver may challenge the report's accuracy and ask the company for another copy at no charge within 60 days. The notice can be oral, written, or electronic, but a written copy is easier to prove.
