Level 2 Background Check: What It Covers, Who Needs One in NEMT, and How to Get One

What a Level 2 background check is

Level 2 is a screening standard written into Florida law. Section 435.04 of the 2026 Florida Statutes calls for a security background investigation that includes fingerprinting for a statewide criminal history check through the Florida Department of Law Enforcement (FDLE), a national criminal history check through the FBI, and local criminal records checks through local law enforcement. It also searches the sexual predator and sexual offender registries of every state where the person lived during the previous 5 years. The Agency for Health Care Administration (AHCA), which runs the state’s Care Provider Background Screening Clearinghouse, calls it Florida’s highest level of background check.

The fingerprints are what set it apart. FDLE says the FBI requires fingerprints sent electronically before it will run a state and national criminal history check. Those checks are open only to government agencies, for licensing and employment that Florida law authorizes. So a NEMT company never buys a Level 2 from a website. It starts one through the Clearinghouse, and the agency that oversees the job decides whether the person is eligible.

Federal Medicaid rules, and states such as Arizona and Illinois, call the same kind of check a fingerprint-based criminal background check. When a state Medicaid agency screens a provider type as high risk, it must require fingerprints from the provider and from anyone with a 5 percent or greater ownership interest (42 CFR 455.434 and 455.450). CMS’s Medicaid Transportation Coverage Guide (SMD 23-006, September 28, 2023) says states may raise NEMT from the minimum limited risk level to moderate or high, which adds site visits or a fingerprint check. States may also add background checks on drivers at any risk level.

Level 1 vs Level 2 background checks

Florida has two screening levels, and the difference is fingerprints. Level 1 is a name-based search, so it can only find records filed under the name and birth date it is given. Level 2 ties the search to the person’s prints and reaches the FBI’s national records.

	Level 1	Level 2
Florida law	Section 435.03	Section 435.04
What it searches	Employment history, a statewide criminal check through FDLE, and the Dru Sjodin National Sex Offender Public Website. Local checks are optional.	FDLE and FBI criminal history by fingerprint, local law enforcement records, and sex offender registries in every state lived in during the last 5 years
Fingerprints	No	Yes, taken electronically by a Livescan vendor
How it is ordered	The employer sends the person’s details to FDLE within 5 working days of getting them	The employer or provider starts it in the Clearinghouse, then the person books a Livescan appointment
Cost, September 2026	$24 for a public FDLE search, plus a $1 card fee for the online instant search	$60 plus the Livescan vendor’s fee
What disqualifies	The offenses listed in section 435.04(2), plus domestic violence	The same list, plus Medicaid and health care crimes when the screening is for Medicaid
Who needs it in a Florida NEMT company	Drivers	Owners, officers, and managing employees

Both levels disqualify a person for a pending arrest, a guilty finding or plea, including no contest, or an unsealed juvenile delinquency finding for any listed offense. Section 435.05 requires the employer to tell the person whether the screening found disqualifying information.

Who needs a Level 2 in a NEMT company

In Florida

Section 409.907(8) of the 2026 Florida Statutes requires a Level 2 screening through AHCA for each principal of a Medicaid provider. Principals are officers, directors, billing agents, managing employees, affiliated persons, and any partner or shareholder with an ownership interest of 5 percent or more. The provider pays for the checks.

The Florida Medicaid Provider Enrollment Policy (February 2026, in rule 59G-1.060 effective April 8, 2026) asks for fingerprints from every person disclosed in the application, requested and tracked through the Clearinghouse. The application must include proof of a Medicaid-eligible fingerprint-based criminal background check. That policy lists non-emergency transportation companies as limited categorical risk, but the fingerprints are still required because state law demands them for Medicaid providers. Health plans then treat an enrolled provider as having passed the Level 2 check, under the plan contract updated July 1, 2026.

Person in your company	What Florida Medicaid requires	Where it comes from
Owner, partner, or shareholder with 5 percent or more	Level 2	Section 409.907(8)(a)
Officer, director, billing agent, or managing employee	Level 2	Section 409.907(8)(a)
Anyone else named on your Medicaid application	Fingerprints through the Clearinghouse	Provider Enrollment Policy, February 2026
Driver you employ or contract	Level 1, or an equivalent the law allows	Section 409.907(8)(a)4
Rideshare driver on Medicaid trips	Level 1, or procedures AHCA finds functionally equivalent	Section 316.87(2)

Drivers get a lighter check by law. Section 409.907(8)(a)4 says NEMT drivers who work for a transportation company, a rideshare company, or a broker are not subject to Level 2 but must pass Level 1. Florida’s Non-Emergency Transportation Services Coverage Policy (November 2019) says the same for rideshare drivers. The health plan contract still requires every driver to pass background checks and meet every qualification in law and rule, so read each broker agreement for its own list. See the Florida state guide for the full enrollment steps.

Other Florida programs set their own rules. As of September 2026, AHCA’s Clearinghouse lists drivers among the positions in Department of Elder Affairs programs that need Level 2 screening. If you carry riders for an aging services provider, ask it which level it requires.

A nonprofit’s unpaid volunteer directors can be excused from screening. Each director and the organization must file an affidavit, under penalty of perjury, that the director takes no pay, stays out of day-to-day decisions, and has no financial interest, and that no family member has one.

In other states

Other states use their own fingerprint checks under other names. A few examples a NEMT owner runs into:

State	Who is fingerprinted	Details
Arizona	AHCCCS screens NEMT providers (type 28) as high risk. Individual NEMT providers, owners of 5 percent or more, and the directors, executive directors, CEOs, and presidents on your Arizona Corporation Commission record are fingerprinted through the Department of Public Safety.	Another state’s FBI check or clearance card is not accepted (PEP-902, revised December 17, 2024). On health plan trips, a driver who carries a 16 or 17 year old member without a guardian needs a Level I fingerprint clearance card (Policy 310-BB, effective October 1, 2026).
Illinois	Officers, owners of 5 percent or more, partners, sole proprietors, and each person with management responsibility	Prints go to an Illinois State Police approved vendor within 30 days after the Medicaid application, at the company’s cost (89 Ill. Adm. Code 140.498).
Delaware	All owners, officers, and drivers of a public carrier	Each gets a State Bureau of Identification report using form PC-24 from the Office of Public Carrier Regulation (form PC-15, revised August 22, 2023). As of September 2026, a certified state and federal history costs $85.

Arizona’s Level I card and Florida’s Level 2 are unrelated despite the similar names. Do not assume a check from one state carries over to another: Arizona, for one, accepts only its own.

How to request a Level 2 screening in Florida

The company starts the screening, not the person being screened. AHCA tells job seekers to ask the employer to start it.

1. Register in the Clearinghouse. Go to the Clearinghouse Results Website, enter your email, and follow the prompts. AHCA must approve your access before you can continue.
2. Start a new screening. Enter the person’s full name and middle initial, Social Security number (or individual taxpayer identification number), date of birth, mailing address, sex, and race, which section 435.12 requires. Confirm the privacy forms. The system assigns the ORI number that routes the results.
3. Book the fingerprints. The person picks a Livescan vendor from the list in the Clearinghouse and brings the Livescan request form, a valid photo ID, and payment. The $60 screening fee and the vendor’s own fee are paid to the vendor. Ask for the Transaction Control Number (TCN) to track the prints. The vendor also takes a photo for the person’s profile.
4. Watch the status. The My Screenings tab shows when a screening is in process and when a determination is made. Employers are also told when a person’s eligibility changes.
5. Report the person’s status. Since January 1, 2024, section 435.12 requires employers to report a person’s initial status, and any change such as a new hire or a departure, within 5 business days.
6. Renew every 5 years. Retained prints expire after 5 years. Renewal costs $42 and opens 60 days before the expiration date.

If the FBI finds the prints unreadable, the person gets a letter to take back to the same vendor for a rescan. As of September 2026, the person has 180 days from the first rejection to redo the prints without paying the FBI fee again.

What a Level 2 costs and how long it takes

Screening	Cost, September 2026	How it is paid
New Level 2 screening	$60 plus the Livescan vendor’s fee	To the vendor when booking. Includes 5 years of print retention.
Renewal	$42	Through the Clearinghouse, by check or card, starting 60 days before expiration
Resubmission after a break of more than 90 days	$12 (since January 1, 2025)	Through the Clearinghouse
Agency review, to share a screening already on file	Free	Through the Clearinghouse
Level 1 FDLE search	$24, plus a $1 card fee online	To FDLE by debit or credit card

AHCA’s FAQ puts the full Level 2 process at 7 to 10 business days. The prints usually reach FDLE within 24 to 72 hours, and the review generally takes 5 to 7 business days after FDLE’s results arrive. Book owner screenings before you apply to Medicaid so the results are ready. See how to become a Medicaid transportation provider for the order of the other steps.

What disqualifies someone, and how exemptions work

Section 435.04(2) lists the disqualifying offenses. They include murder, manslaughter, vehicular homicide, kidnapping, aggravated assault and battery, sexual battery and other sexual offenses, child abuse, abuse or exploitation of elderly or disabled adults, arson, burglary, felony theft and robbery, and felony drug offenses. Domestic violence also disqualifies, wherever it happened.

When the screening is for Medicaid, section 435.04(4) adds crimes involving Medicaid, Medicare, or any health care program, patient abuse or neglect, controlled substances, fraud, theft, embezzlement, and falsifying records. Any violation of a law or rule governing Medicaid or Medicare counts too. A separate federal check applies to everyone in your company: no one on the OIG exclusion list can work on Medicaid trips.

If a screening shows a disqualifying record, chapter 435 sets out what happens next:

• Written notice. The employer or agency tells the person in writing which record caused the problem (section 435.06). The only way to contest the disqualification itself is to prove mistaken identity.
• A chance to fix the FBI record. Under 28 CFR 50.12, the person must get a chance to complete or challenge the FBI record before a denial based on it.
• An exemption request. The agency head may grant an exemption for a felony once at least 2 years have passed since the person finished the sentence and supervision, and for a misdemeanor once the sentence is complete (section 435.07). Court-ordered fines and restitution must be paid first. The person must show clear and convincing evidence of rehabilitation, and a denial can be contested at a hearing under chapter 120.
• No exemption at all for a registered sexual predator, a career offender, or a registered sexual offender. A pardon or restored civil rights alone does not remove a disqualification.

Chapter 435 also sets duties for the employer. A person cannot have contact with vulnerable people in a screened role until the screening is complete, though training and orientation without that contact are allowed. Anyone arrested for a disqualifying offense must be removed from that contact until the arrest is resolved. Each screened employee signs an attestation, under penalty of perjury, that they qualify and will report any arrest for a disqualifying offense right away (section 435.05).

Name-based checks from a screening company

Many NEMT owners also buy name-based checks from a private screening company, for drivers or for states that require no fingerprints. The FTC says those reports are consumer reports under the Fair Credit Reporting Act, and the law sets the steps:

1. Give a written disclosure in a standalone document, not inside the job application.
2. Get written permission from the applicant. If you will pull reports during employment too, the permission must say so clearly.
3. Certify to the company that you followed the law and will not misuse the report.
4. Before rejecting someone, send a pre-adverse action notice with a copy of the report and “A Summary of Your Rights Under the Fair Credit Reporting Act.”
5. After deciding, send an adverse action notice with the screening company’s contact details, a statement that it did not make the decision, and the person’s right to dispute the report and get a free copy within 60 days.
6. Destroy the report securely when you are done.

A name check pairs well with a motor vehicle record check, which shows the driving side of the record. Our NEMT driver background check guide covers the full set of checks, and the driver file checklist tracks what each file needs.