Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.09 - MEDICAID BASIC PLAN BENEFITS › Section 16.03.09.009 - BACKGROUND CHECK REQUIREMENTS

Current through August 31, 2023
01.
Compliance With Background Checks
. Background checks are required
			 for certain types of providers under these rules. Providers who are required to
			 have a background check must comply with IDAPA 16.05.06, "Criminal History and
			 Background Checks." (7-1-23)T
02.
Department-Issued Variances to Requirements for a Clearance
.
			 (7-1-23)T
a. Notwithstanding those provider
			 types required to obtain a clearance or enhanced clearance under these rules or
			 under IDAPA 16.05.06, "Criminal History and Background Checks," the Department
			 may allow variances to clearance requirements under certain circumstances.
			 Providers who are subject to a background check must still complete and
			 notarize an application for a background check. (7-1-23)T
b. In cases where the application process
			 results in a denial rather than a clearance, and the denial is due to the
			 applicant's prior convictions for disqualifying drug and alcohol-related
			 offenses, the applicant may, with prior written approval of the Department,
			 deliver covered Medicaid Peer Support and Recovery Coaching services.
			 (3-17-22)
c. A variance may be
			 granted on a case-by-case basis upon review by the Department of any underlying
			 facts and circumstances in each individual case. The Department will establish
			 the process for the administrative review which will be conducted separate from
			 the background check unit. During the Department's review, the following
			 factors may be considered: (7-1-23)T
i. The
			 severity or nature of the crimes or other findings; (3-17-22)
ii. The period of time since the incidents
			 occurred; (3-17-22)
iii. The number
			 and pattern of incidents being reviewed; (3-17-22)
iv. Circumstances surrounding the incidents
			 that would help determine the risk of repetition; (3-17-22)
v. The relationship between the incidents and
			 the position sought; (3-17-22)
vi.
			 Activities since the incidents, such as continuous employment, education,
			 participation in treatment, completion of a problem-solving court or other
			 formal offender rehabilitation, payment of restitution, or any other factors
			 that may be evidence of rehabilitation; (3-17-22)
vii. A pardon granted by a state governor or
			 the President of the United States; (7-1-23)T
viii. The falsification or omission of
			 information on the self-declaration form and other supplemental forms
			 submitted; and (3-17-22)
ix. Any
			 other factor deemed relevant to the review. (3-17-22)
d. A variance granted under these rules is
			 not a criminal history and background check clearance and does not set a
			 precedent for subsequent application for variance. The Department may revoke a
			 variance when it identifies a risk to participants' health and safety.
			 Providers who have been granted a variance must still meet all other Department
			 requirements for Medicaid coverage and reimbursement of Peer Support and
			 Recovery Coaching services, and are prohibited from delivering any other
			 covered Medicaid service without the required clearance or Department enhanced
			 clearance. (3-17-22)