FACIS Background Check: The 2025 Guide for Healthcare Employers

Healthcare fraud costs the United States around $100 billion each year, with individual cases often exceeding $1 million in losses. One of the most effective ways healthcare organizations can protect themselves is by running thorough FACIS background checks on all staff who interact with patients or handle sensitive data. FACIS Background Check screen for individuals who have been excluded or sanctioned from federal healthcare programs, helping you avoid costly compliance issues.

Whether you’re a small clinic or a large health system, these checks are essential for maintaining eligibility to work with Medicare, Medicaid, and other government-funded programs.

What is a FACIS Background Check?

The Fraud and Abuse Control Information System (FACIS) is a comprehensive screening tool that searches over 5,000 federal and state sources to identify individuals or entities excluded from participating in federal healthcare programs due to fraud, abuse, or disciplinary actions. It goes beyond standard background checks by focusing specifically on healthcare-related violations.

FACIS Background Check operates on a preventive model, helping healthcare organizations avoid hiring individuals who pose risks to patient safety or compliance. By continuously monitoring state boards and federal agencies, FACIS ensures your hiring process aligns with regulatory standards and protects your organization from costly penalties.

Why Healthcare Organizations Must Conduct FACIS Background Check

Patient Safety Protection

Patient safety remains the cornerstone of quality healthcare delivery, and FACIS screening plays a crucial role in maintaining these standards. The system identifies healthcare professionals who have engaged in patient abuse, neglect, financial exploitation, or other harmful behaviors that directly threaten patient well-being.

When healthcare providers fail to screen adequately, they risk exposing vulnerable patients to individuals with documented histories of misconduct. This is particularly critical in settings serving elderly patients, children, or individuals with disabilities.

Healthcare Fraud Prevention

The healthcare industry faces unprecedented challenges from fraudulent activities that drain resources and compromise care quality. FACIS checks help organizations avoid hiring individuals with proven track records of healthcare fraud, including billing scheme participation, kickback arrangements, or false claim submissions.

Recent data from federal agencies shows that healthcare fraud cases have increased significantly, with median losses exceeding $1 million per incident. Organizations that implement comprehensive screening programs demonstrate significantly lower fraud incident rates.

Regulatory Compliance

Healthcare organizations receiving government funding must comply with strict exclusion screening requirements established by the Office of Inspector General and other federal agencies. The compliance program guidance mandates that covered entities cannot employ or contract with excluded individuals except under very limited circumstances.

Failure to maintain proper screening protocols can result in severe penalties, including:

• Loss of Medicare and Medicaid contracting privileges
• Substantial financial fines
• Required compliance monitoring
• Business interruption costs

FACIS Level 1 vs Level 3: Key Differences

Understanding the differences between FACIS Level 1 and Level 3 searches is crucial for making informed hiring decisions about your organization’s screening needs.

FACIS Level 1 Search

FACIS Level 1 represents the baseline screening that satisfies basic regulatory requirements for healthcare organizations receiving federal funding. This level searches essential federal sources while providing cost-effective compliance.

Key Data Sources Include:

• Office of Inspector General List of Excluded Individuals/Entities (LEIE)
• Drug Enforcement Administration (DEA) exclusions
• Treasury Department Office of Foreign Assets Control listings
• Food and Drug Administration sanctions
• Medicare and state Medicaid exclusions
• TRICARE exclusion database
• General Services Administration debarments

FACIS Level 3 Search

FACIS Level 3 search represents the gold standard for healthcare exclusion screening, incorporating all Level 1 data sources plus thousands of additional state and federal databases. This comprehensive approach provides maximum protection and exceeds minimum federal requirements.

Enhanced Coverage Includes:

• All federal sources from Level 1
• 2,500+ additional state-level databases
• Licensing board disciplinary actions across all states
• Federal district attorney enforcement actions
• State attorney general sanctions
• Historical exclusion data dating back to 1992
• HEAT task force records

Who Needs FACIS Screening?

The scope of healthcare professionals subject to FACIS screening requirements extends far beyond traditional clinical roles. Modern healthcare delivery involves numerous personnel who have access to patients, medical records, or billing systems.

Licensed Medical Professionals

• Medical Doctors (MDs) and Doctors of Osteopathy (DOs)
• Nurse Practitioners and Physician Assistants
• Registered Nurses (RNs) and Licensed Practical Nurses (LPNs)
• Certified Nursing Assistants (CNAs)
• Pharmacists and Pharmacy Technicians

Specialized Healthcare Providers

• Physical Therapists and Respiratory Therapists
• Radiologists and Medical Technicians
• Clinical Laboratory Personnel
• Emergency Medical Technicians (EMTs) and Paramedics

Mental Health Professionals

• Licensed Professional Counselors
• Psychologists and Social Workers
• Substance Abuse Counselors

Support Personnel

• Medical Assistants and Administrative Staff
• Billing and Coding Specialists
• Patient Transport Personnel
• Existing employees in patient-facing roles

Key FACIS Data Sources

The control information system FACIS, draws from multiple databases to provide comprehensive screening coverage:

Federal Data Sources

• Office of Inspector General (OIG) exclusions
• Systems for Award Management (SAM)
• Drug Enforcement Administration records
• Treasury Dept sanctions lists
• State Dept debarment records

State-Level Sources

• State Medicaid exclusions
• Professional licensing board actions
• State attorney general enforcement
• Healthcare facility sanctions
• Excluded Parties List System records

The system includes over 75,000 new records monthly, ensuring healthcare organizations have access to the most current exclusion information available.

FACIS Screening Process

Step 1: Information Collection

Background screening starts by collecting key candidate details, including full legal name, date of birth, Social Security number, professional license numbers, and previous addresses. These details form the foundation for verifying identity, checking credentials, and ensuring regulatory compliance throughout the hiring process.

Step 2: Database Search

The FACIS search automatically queries thousands of federal and state databases, using advanced algorithms to cross-reference candidate information against lists of excluded or sanctioned individuals and entities. This process helps healthcare organizations quickly identify compliance risks and make informed hiring decisions with confidence.

Step 3: Results Review

Qualified analysts carefully review potential matches to eliminate false positives and ensure accurate results. This layer of human oversight is essential for maintaining compliance with industry standards, reducing legal risk, and protecting candidate rights throughout the screening process.

Step 4: Reporting

FACIS results are delivered through secure online portals and can integrate directly with existing HR systems, allowing for seamless workflow management. This streamlined delivery ensures quick access to vital screening information while maintaining data security and operational efficiency.

Best Practices for FACIS Implementation

Timing Considerations

Conduct FACIS checks before extending job offers, screen current employees annually or before contract renewals, and use ongoing monitoring for real-time alerts. This proactive approach helps ensure continuous compliance and reduces risk.

Compliance Requirements

Always obtain written consent from candidates, follow FCRA guidelines, maintain documentation for audits, and establish clear adverse action procedures. These steps ensure legal compliance and protect both your organization and applicants.

Integration Strategy

Enhance FACIS screening by combining it with criminal background checks, employment and education verification, license validation, and drug screening when appropriate. This comprehensive approach strengthens your hiring process and minimizes risk.

Handling FACIS Results

When FACIS checks identify potential matches, healthcare organizations must follow established procedures:

Match Evaluation

Carefully review the nature and details of any exclusions, assess their relevance to the role, and consider the timeframe and severity of the violations. Be sure to document your decision-making process to support compliance and transparency.

Adverse Action Process

If employment is denied based on FACIS screening results:

1. Provide pre-adverse action notice
2. Include a copy of the background report
3. Allow time for candidate response
4. Complete final adverse action if necessary
5. Maintain all documentation

Cost Considerations and ROI

While FACIS screening adds to upfront hiring costs, the return on investment is significant. By helping avoid costly compliance penalties, prevent patient safety incidents, reduce fraud-related losses, and protect your organization’s reputation, most healthcare providers see a positive ROI within the first year.

Conclusion

FACIS background checks are a critical safeguard in the healthcare sector, helping organizations prevent fraud, protect patient safety, and ensure regulatory compliance. By identifying individuals who have been excluded or sanctioned, FACIS supports responsible hiring practices and strengthens operational integrity. Whether you’re a clinic, hospital, or healthcare system, incorporating this level of thorough screening reduces risk and reinforces your commitment to quality care.

Want to protect your healthcare organization from costly compliance issues and hiring mistakes? Sapphire Check provides reliable, compliant FACIS background checks with expert analysis and seamless integration. Ensure your team meets the highest standards with our thorough screening process. Contact us today to get started.

FAQs

What does FACIS stand for?

FACIS stands for Fraud and Abuse Control Information System, a comprehensive database that searches federal and state sources to identify individuals excluded from participating in healthcare programs.

What is a FACIS Level 3?

FACIS Level 3 is the most comprehensive exclusion screening that searches over 5,000 data sources, including all federal databases plus thousands of additional state-level sources, providing enhanced protection beyond minimum federal requirements.

What is the highest level of a background check?

FACIS Level 3 represents the highest level of healthcare exclusion screening, while comprehensive background checks typically combine multiple screenings, including criminal history, employment verification, education checks, and professional license verification.

What is meant by a background check?

A background check is a screening process that verifies an individual’s personal, professional, and criminal history to help employers make informed hiring decisions and ensure workplace safety.