If you are involved in background checks for healthcare industry professionals, you know what FACIS is. You can skip down to the bold part.
If you don’t screen healthcare professionals but want to understand, FACIS is the Fraud and Abuse Control Information System, a search that screens the sanction history of individuals and entities in the healthcare industry. FACIS is split into 3 levels (1, 1M and 3 – yes, it’s weird), with each level going more in-depth than the previous.
The FACIS search is primarily used to help healthcare entities abide by regulations that limit who can participate in federal healthcare programs. Individuals and entities who have committed fraud or abuse of the program are typically excluded from participating in these programs, meaning that the programs will not pay excluded providers for any services provided, nor will they pay any other doctor the patient goes to at the referral of the excluded provider. (As with any rule, there are exceptions but that’s a whole other rabbit hole.)
Now for the interesting part.
What you may not know, even if you work in healthcare, is that a FACIS Level 1 search is not sufficient to fully determine whether a person has been excluded. For that you have to get a Level 1M search, which includes all the sources that are found in the Level 1 search, plus the ever-important State Medicaid sanctions sources, HEAT (Medicaid Taskforce) sources, Attorney General Notice and Release sources, and state-level procurement/contractor debarment sources.
A FACIS Level 3 search is the most thorough of all. A Level 3 search will include everything in a Level 1M search, plus any data available from all publishing jurisdictions in the United States from all disciplinary and licensing boards for all professions within those jurisdictions – not just MDs and DOs. FACIS Level 3 is considered to be the gold standard for sanction screening.
If you’re running a FACIS search, make sure that your search meets requirements and helps ensure that your providers aren’t on the excluded list.