the abuse and neglect registries of another 
State in the case where a prospective employee 
previously resided in that State, State criminal 
history records, the records of any proceedings 
in the State that may contain disqualifying in-
formation about prospective employees (such as 
proceedings conducted by State professional li-
censing and disciplinary boards and State Med-
icaid Fraud Control Units), and Federal crimi-
nal history records, including a fingerprint 
check using the Integrated Automated Finger-
print Identification System of the Federal Bu-
reau of Investigation; and 
(B) require States to describe and test 
methods that reduce duplicative fingerprinting, 
including providing for the development of ‘‘rap 
back’’ capability by the State such that, if a di-
rect patient access employee of a long-term care 
facility or provider is convicted of a crime fol-
lowing the initial criminal history background 
check conducted with respect to such employee, 
and the employee’s fingerprints match the 
prints on file with the State law enforcement 
department, the department will immediately 
inform the State and the State will immediately 
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inform the long-term care facility or provider 
which employs the direct patient access em-
ployee of such conviction. 
(4) STATE REQUIREMENTS.—An agreement en-
tered into under paragraph (1) shall require that a 
participating State— 
(A) be responsible for monitoring compli-
ance with the requirements of the nationwide 
program; 
(B) have procedures in place to— 
(i) conduct screening and criminal his-
tory background checks under the nation-
wide program in accordance with the re-
quirements of this section; 
(ii) monitor compliance by long-term 
care facilities and providers with the proce-
dures and requirements of the nationwide 
program; 
(iii) as appropriate, provide for a pro-
visional period of employment by a long- 
term care facility or provider of a direct 
patient access employee, not to exceed 30 
days, pending completion of the required 
criminal history background check and, in 
the case where the employee has appealed 
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the results of such background check, 
pending completion of the appeals process, 
during which the employee shall be subject 
to direct on-site supervision (in accordance 
with procedures established by the State to 
ensure that a long-term care facility or 
provider furnishes such direct on-site su-
pervision); 
(iv) provide an independent process by 
which a provisional employee or an em-
ployee may appeal or dispute the accuracy 
of the information obtained in a back-
ground check performed under the nation-
wide program, including the specification 
of criteria for appeals for direct patient ac-
cess employees found to have disqualifying 
information which shall include consider-
ation of the passage of time, extenuating 
circumstances, demonstration of rehabilita-
tion, and relevancy of the particular dis-
qualifying information with respect to the 
current employment of the individual; 
(v) provide for the designation of a 
single State agency as responsible for— 
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(I) overseeing the coordination of 
any State and national criminal his-
tory background checks requested by 
a long-term care facility or provider 
(or the designated agent of the long- 
term care facility or provider) utilizing 
a search of State and Federal crimi-
nal history records, including a finger-
print check of such records; 
(II) overseeing the design of ap-
propriate privacy and security safe-
guards for use in the review of the re-
sults of any State or national criminal 
history background checks conducted 
regarding a prospective direct patient 
access employee to determine whether 
the employee has any conviction for a 
relevant crime; 
(III) immediately reporting to 
the long-term care facility or provider 
that requested the criminal history 
background check the results of such 
review; and 
(IV) in the case of an employee 
with a conviction for a relevant crime 
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that is subject to reporting under sec-
tion 1128E of the Social Security Act 
(42 U.S.C. 1320a–7e), reporting the 
existence of such conviction to the 
database established under that sec-
tion; 
(vi) determine which individuals are 
direct patient access employees (as defined 
in paragraph (6)(B)) for purposes of the 
nationwide program; 
(vii) as appropriate, specify offenses, 
including convictions for violent crimes, for 
purposes of the nationwide program; and 
(viii) describe and test methods that 
reduce duplicative fingerprinting, including 
providing for the development of ‘‘rap 
back’’ capability such that, if a direct pa-
tient access employee of a long-term care 
facility or provider is convicted of a crime 
following the initial criminal history back-
ground check conducted with respect to 
such employee, and the employee’s finger-
prints match the prints on file with the 
State law enforcement department— 
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(I) the department will imme-
diately inform the State agency des-
ignated under clause (v) and such 
agency will immediately inform the fa-
cility or provider which employs the 
direct patient access employee of such 
conviction; and 
(II) the State will provide, or will 
require the facility to provide, to the 
employee a copy of the results of the 
criminal history background check 
conducted with respect to the em-
ployee at no charge in the case where 
the individual requests such a copy. 
(5) PAYMENTS.— 
(A) NEWLY PARTICIPATING STATES.— 
(i) IN GENERAL.—As part of the ap-
plication submitted by a State under para-
graph (1)(A)(iii), the State shall guar-
antee, with respect to the costs to be in-
curred by the State in carrying out the na-
tionwide program, that the State will make 
available (directly or through donations 
from public or private entities) a particular 
amount of non-Federal contributions, as a 
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condition of receiving the Federal match 
under clause (ii). 
(ii) FEDERAL MATCH.—The payment 
amount to each State that the Secretary 
enters into an agreement with under para-
graph (1)(A) shall be 3 times the amount 
that the State guarantees to make avail-
able under clause (i), except that in no 
case may the payment amount exceed 
$3,000,000. 
(B) 
PREVIOUSLY
PARTICIPATING 
STATES.— 
(i) IN GENERAL.—As part of the ap-
plication submitted by a State under para-
graph (1)(B)(iii), the State shall guar-
antee, with respect to the costs to be in-
curred by the State in carrying out the na-
tionwide program, that the State will make 
available (directly or through donations 
from public or private entities) a particular 
amount of non-Federal contributions, as a 
condition of receiving the Federal match 
under clause (ii). 
(ii) FEDERAL MATCH.—The payment 
amount to each State that the Secretary 
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enters into an agreement with under para-
graph (1)(B) shall be 3 times the amount 
that the State guarantees to make avail-
able under clause (i), except that in no 
case may the payment amount exceed 
$1,500,000. 
(6) DEFINITIONS.—Under the nationwide pro-
gram: 
(A) LONG-TERM CARE FACILITY OR PRO-
VIDER.—The term ‘‘long-term care facility or 
provider’’ means the following facilities or pro-
viders which receive payment for services under 
title XVIII or XIX of the Social Security Act: 
(i) A skilled nursing facility (as de-
fined in section 1819(a) of the Social Secu-
rity Act (42 U.S.C. 1395i–3(a)). 
(ii) A nursing facility (as defined in 
section 1919(a) of such Act (42 U.S.C. 
1396r(a)). 
(iii) A home health agency. 
(iv) A provider of hospice care (as de-
fined in section 1861(dd)(1) of such Act 
(42 U.S.C. 1395x(dd)(1)). 
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(v) A long-term care hospital (as de-
scribed in section 1886(d)(1)(B)(iv) of 
such Act (42 U.S.C. 1395ww(d)(1)(B)(iv)). 
(vi) A provider of personal care serv-
ices. 
(vii) A provider of adult day care. 
(viii) A residential care provider that 
arranges for, or directly provides, long- 
term care services, including an assisted 
living facility that provides a level of care 
established by the Secretary. 
(ix) An intermediate care facility for 
the mentally retarded (as defined in sec-
tion 1905(d) of such Act (42 U.S.C. 
1396d(d)). 
(x) Any other facility or provider of 
long-term care services under such titles as 
the participating State determines appro-
priate. 
(B) 
DIRECT
PATIENT
ACCESS
EM-
PLOYEE.—The term ‘‘direct patient access em-
ployee’’ means any individual who has access to 
a patient or resident of a long-term care facility 
or provider through employment or through a 
contract with such facility or provider and has 
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duties that involve (or may involve) one-on-one 
contact with a patient or resident of the facility 
or provider, as determined by the State for pur-
poses of the nationwide program. Such term 
does not include a volunteer unless the volun-
teer has duties that are equivalent to the duties 
of a direct patient access employee and those 
duties involve (or may involve) one-on-one con-
tact with a patient or resident of the long-term 
care facility or provider. 
(7) EVALUATION AND REPORT.— 
(A) EVALUATION.—The Inspector General 
of the Department of Health and Human Serv-
ices shall conduct an evaluation of the nation-
wide program. 
(B) REPORT.—Not later than 180 days 
after the completion of the nationwide program, 
the Inspector General of the Department of 
Health and Human Services shall submit a re-
port to Congress containing the results of the 
evaluation conducted under subparagraph (A). 
(b) FUNDING.— 
(1) NOTIFICATION.—The Secretary of Health 
and Human Services shall notify the Secretary of 
the Treasury of the amount necessary to carry out 
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the nationwide program under this section for the 
period of fiscal years 2010 through 2012, except 
that in no case shall such amount exceed 
$160,000,000. 
(2) TRANSFER OF FUNDS.—Out of any funds 
in the Treasury not otherwise appropriated, the Sec-
retary of the Treasury shall provide for the transfer 
to the Secretary of Health and Human Services of 
the amount specified as necessary to carry out the 
nationwide program under paragraph (1). Such 
amount shall remain available until expended. 
SEC. 4. MANDATORY STATE USE OF NATIONAL CORRECT 
CODING INITIATIVE. 
(a) IN GENERAL.—Section 1903(r) of the Social Se-
curity Act (42 U.S.C. 1396b(r)), as amended by section 
3(a) of the QI Program Supplemental Funding Act of 
2008 (Public Law 110–379), is amended— 
(1) in paragraph (1)(B)— 
(A) in clause (ii), by striking ‘‘and’’ at the 
end; 
(B) in clause (iii), by adding ‘‘and’’ after 
the semicolon; and 
(C) by adding at the end the following new 
clause: 
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‘‘(iv) effective for claims filed on or 
after October 1, 2010, incorporate compat-
ible methodologies of the National Correct 
Coding Initiative administered by the Sec-
retary (or any successor initiative to pro-
mote correct coding and to control im-
proper coding leading to inappropriate pay-
ment) and such other methodologies of 
that Initiative (or such other national cor-
rect coding methodologies) as the Sec-
retary identifies in accordance with para-
graph (4);’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(4) Not later than September 1, 2010, the Secretary 
shall do the following: 
‘‘(A) Identify those methodologies of the Na-
tional Correct Coding Initiative administered by the 
Secretary (or any successor initiative to promote cor-
rect coding and to control improper coding leading 
to inappropriate payment) which are compatible to 
claims filed under this title. 
‘‘(B) Identify those methodologies of such Ini-
tiative (or such other national correct coding meth-
odologies) that should be incorporated into claims 
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