# NEMT Driver Background Checks in 2027: What to Run and How Often

Canonical URL: https://nemtguide.com/guides/nemt-driver-background-check/ · Updated 2026-09-29

A NEMT driver background check covers criminal history, sex offender registries, the driving record, and the federal and state exclusion lists. Run all four before the first ride. MTM Health's 2023 standard contract then wants a new criminal check and driving record every year, and Medicaid guidance calls for exclusion searches every month. When a screening company runs a check, federal law requires written notice and consent first.

- Run four checks before the first ride: criminal history, sex offender registries, the driving record, and the OIG, SAM.gov, and state exclusion lists.
- Search the exclusion lists every month, and plan on a new criminal check and driving record every year.
- Match each broker's definition of a background check. MTM Health's calls for national, county, and Social Security number searches.
- Fingerprint checks run through state programs, such as Florida's Level 2 screening for owners and Minnesota's background study for all staff.
- When a screening company runs a check, give a stand-alone disclosure, get written consent, and send notices before and after you turn someone down.

NEMT drivers are alone with riders who are often older, sick, or disabled. That is why every broker and state wants proof that each driver was checked before the first ride. The checks themselves are ordinary. What changes from one contract to the next is how deep each one goes, who runs it, and how often you repeat it.

## What a NEMT driver background check includes

A complete background check for a NEMT driver has four main parts, plus an identity trace that a screening company runs with the criminal search. The drug test is separate, with its own rules, in [NEMT driver drug testing](https://nemtguide.com/guides/nemt-driver-drug-testing/).

| Check | What it finds | Where it comes from |
|---|---|---|
| Criminal history | Convictions and pending charges in county, state, and national records | A screening company, your state police, or a state screening program |
| Sex offender registries | Current registrations in every state | The Justice Department's national search at NSOPW.gov, and your state's registry |
| Driving record | License status, tickets, crashes, and suspensions | Your state's driver licensing agency |
| Exclusion lists | People barred from federal and state health programs | The HHS OIG list, SAM.gov, and your state Medicaid list |
| Identity trace | Past names, past addresses, and a Social Security number match | A screening company, as part of the criminal check |

MTM Health's standard provider contract, in the January 1, 2023 version Pennsylvania posts, shows what a full criminal check means to a broker. It defines one as a federal and FBI check or the equivalent. That includes a national criminal record search, a Social Security number trace, a national criminal database search, and county criminal court searches for each past address and name. A single statewide search does not meet that definition.

The national sex offender search is free. The Justice Department says NSOPW.gov needs no membership and links the public registries of all 50 states, the District of Columbia, the five principal territories, and participating tribes.

## What federal law requires and what states and brokers add

Federal Medicaid law sets a short list for every NEMT driver. Section 1902(a)(87) of the Social Security Act requires each state to make sure that:

1. Every NEMT provider and driver it pays is not excluded from federal health programs or listed on the HHS OIG exclusion list.
2. Each driver has a valid driver's license.
3. Each provider has a process to deal with any violation of a state drug law.
4. Each provider has a process to disclose each driver's driving history, including traffic violations, to the state Medicaid program.

CMS explains the rule in its Medicaid Transportation Coverage Guide (SMD 23-006, September 28, 2023). The guide says federal law sets no other basic driver standards, so states and brokers write the rest. States may raise NEMT from the lowest screening risk level to moderate or high, which brings site visits or fingerprint-based criminal checks. They may also add background checks on drivers at any risk level.

### State rules for Medicaid rides

| State | Who runs it | What it includes | How often |
|---|---|---|---|
| Texas health plans (handbook version 2.0.1, August 1, 2021) | The plan or its transportation subcontractor | State criminal history through the Department of Public Safety and a national criminal history check. State and national sex offender registries. The OIG, SAM.gov, Texas Inspector General, and Comptroller debarment lists, and the Social Security death file. | Registries and lists before hire and every year. OIG and SAM.gov every month. |
| Virginia (DMAS, May 26, 2026) | The provider, which keeps the results and gives them to the broker | Virginia State Police or national databases, including the sex offender registry. No barrier crimes under Virginia Code 37.2-314(B). | Before the first ride. The broker reviews every driver at least once a year. |
| Louisiana (section 10.3, July 14, 2025) | The State Police, an agency it authorizes, or the FBI | A criminal history check sent straight to the broker, after the driver consents in writing | Every year |
| Rhode Island (MTM Health, July 1, 2026) | The provider | The state Bureau of Criminal Identification, or a national check if the driver has not lived in Rhode Island for 5 straight years. Drivers who live out of state also need their home state's check. | Before hire and every year |
| Georgia (July 1, 2026) | The broker | A background check, documented in the broker's driver records. No sexual or violent crime. A felony in the last 5 years needs review by the broker and the state. | Before the driver starts |
| Florida (2026 statutes) | The provider | Level 1 for drivers: employment history, a statewide criminal check through the Florida Department of Law Enforcement, and the national sex offender search | Before the driver starts |
| Minnesota (Statutes 174.30) | The provider starts it and the Department of Human Services decides | A background study with fingerprints and a photo, run through the state's NETStudy system | Before the person does any covered work |
| Oregon Health Plan (CareOregon, February 2024) | The provider | A criminal background check that meets Oregon's state background check laws | Before hiring or contracting |

Texas adds two rules worth knowing. Providers must tell the plan in writing within 10 business days about a driver's new conviction, pending felony charge, or registry listing. And the state takes back the plan's payment for any ride given by a driver who was not eligible.

### Broker rules

| Broker | What it asks for | Where it says so |
|---|---|---|
| MTM Health | A criminal check before hire and every year, a 3-year driving record every year, and no one on the OIG or federal excluded parties lists. Immediate notice of any criminal charge or investigation, and of convictions for crimes against a person, alcohol-related driving offenses, and crimes of moral turpitude. | Standard contract, January 1, 2023 version |
| SafeRide Health | National background checks, national sex offender registry checks, motor vehicle reports, and pre-hire drug screens, with documents, during onboarding | Provider page, September 2026 |
| Modivcare | A thorough background check and a clean driving record shown by a motor vehicle report | Provider requirements page, September 2026 |
| Verida | Criminal background checks, plus current drug screens for all owners and drivers, sent with the contracting documents | Provider page, September 2026 |

When a state and a broker set different rules, meet the stricter one for that broker's trips. The full driver list by program is in [NEMT driver requirements](https://nemtguide.com/guides/nemt-driver-requirements/).

## Who in your company needs a check

Drivers are the start, not the end.

- **Drivers, including owners who drive.** MTM Health's contract requires a file for owner-drivers the same as for employees. It defines a driver as anyone the provider directly retains or employs, so contract drivers count.
- **Attendants you employ.** MTM's attendant rules apply to attendants on your staff, not to a family member or caseworker who rides along.
- **Dispatchers, schedulers, and billers.** Minnesota requires background studies for staff who dispatch, schedule, or bill, or who have contact with riders or their private data. Texas covers every employee who works directly with members or can see member records. CMS's 2009 exclusion letter lists services by excluded ambulance drivers and dispatchers among its examples of work Medicaid cannot pay for.
- **Owners and managers.** They are checked through Medicaid enrollment as well. See the owner section below.

## How often to repeat each check

| Check | Before the first ride | After that | Example rule |
|---|---|---|---|
| OIG, SAM.gov, and state exclusion lists | Yes | Every month | CMS letter SMDL #09-001 (January 16, 2009) asks states to require monthly OIG searches. Texas plans search OIG and SAM.gov monthly. |
| Criminal history | Yes | Every year | MTM Health's standard contract, MTM Health in Rhode Island, and Louisiana |
| Sex offender registries | Yes | Every year | Texas health plans |
| Driving record | Yes | Every year | MTM Health's standard contract wants a 3-year record every year |
| Florida Level 2 fingerprint screening (owners and managers) | Before Medicaid enrollment | Renewed every 5 years | Florida keeps retained prints for 5 years |

OIG generally updates its list by the middle of each month with the prior month's actions, so a monthly search keeps pace with it. SAM.gov's exclusion search needs no login, according to GSA's quick start guide.

Keep watching between reruns. Virginia requires its broker to use the DMV's Driver Alert program, which monitors enrolled drivers' records. Ask every driver to tell you the same day about any arrest, charge, ticket, or crash. MTM Health wants immediate notice of criminal charges, and Texas wants new convictions reported within 10 business days.

## Fingerprint checks and name-based checks

A name-based search finds records filed under the name and birth date you give it. A fingerprint check ties the search to the person and can reach FBI records. For employment and licensing, federal rules let the FBI share its records with state and local officials when a state law authorizes it ([28 CFR 50.12](https://www.ecfr.gov/current/title-28/section-50.12)). That is why fingerprint checks for NEMT work run through state programs:

- **Florida.** Owners and managers get a Level 2 screening through the state's Care Provider Background Screening Clearinghouse. As of September 2026, a new screening costs $60 plus the fingerprint vendor's fee and keeps the prints on file for 5 years, and a renewal costs $42. The Clearinghouse says the full process typically takes 7 to 10 business days. See [Level 2 background check](https://nemtguide.com/glossary/level-2-background-check/).
- **Minnesota.** The provider starts each study in NETStudy, and the person gives fingerprints and a photo. The prints go to the state Bureau of Criminal Apprehension, and to the FBI when the law calls for it. State law caps the fee at $44 per study for special transportation providers. No one may drive, assist riders, dispatch, or bill until the state clears them or sets aside a disqualification for your company.
- **Louisiana.** The yearly check must be run by the State Police, an agency the State Police authorizes, or the FBI, and the result goes straight to the broker. Ask the broker which kind of check it accepts.

The same federal rule protects the person. Officials who use an FBI record must give the person a chance to complete or challenge it, and should not deny the job until the person has had a reasonable time to do so.

## Background checks for owners and managers

Medicaid checks the people who own and run your company, not only your drivers.

- **Every state.** The Medicaid agency must confirm the identity and exclusion status of each provider, each person with an ownership or control interest, and each agent and managing employee. It searches the OIG list and the federal excluded parties list, now part of SAM.gov, at least monthly ([42 CFR 455.436](https://www.ecfr.gov/current/title-42/section-455.436)).
- **High-risk states.** When a state rates a provider type as high risk, the provider and each owner of 5 percent or more must give fingerprints. They must also send them within 30 days whenever CMS or the state asks ([42 CFR 455.434](https://www.ecfr.gov/current/title-42/section-455.434)).
- **Florida.** Section 409.907(8) of the 2026 Florida Statutes requires a Level 2 screening of each principal: officers, directors, billing agents, managing employees, affiliated persons, and owners of 5 percent or more. The provider pays for the state and national checks. Drivers need only Level 1.
- **Minnesota.** Owners of 5 percent or more, controlling individuals, and managers need background studies too, and Medicaid can end the enrollment of a company that has not started them.
- **Illinois.** NEMT providers submit to a fingerprint-based criminal background check as part of enrollment, under 89 Ill. Admin. Code 140.498 (handbook of March 11, 2024).

For where these checks fall in enrollment, see [how to become a Medicaid transportation provider](https://nemtguide.com/guides/how-to-become-a-medicaid-transportation-provider/) and the [Florida](https://nemtguide.com/states/florida/) and [Minnesota](https://nemtguide.com/states/minnesota/) state guides.

## The Fair Credit Reporting Act steps

The FTC treats criminal histories, driving records, and employment checks that a screening company supplies to an employer as consumer reports (staff report, July 2011). That brings in the Fair Credit Reporting Act, whatever your company's size. FTC staff also read the law to cover people who are not technically employees, so [1099 drivers](https://nemtguide.com/guides/nemt-drivers-1099-or-w2/) get the same steps.

1. **Disclose first, in writing, on its own page.** The notice that you may get a consumer report must be a document that consists only of that notice ([15 U.S.C. 1681b](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title15-section1681b&num=0&edition=prelim)). It cannot sit inside the job application. The FTC allows a brief description of consumer reports on it.
2. **Get written permission.** The signature can go on the disclosure page. If you plan to run checks during employment too, say so clearly on the form.
3. **Certify to the screening company.** You confirm that you gave the notice, got permission, and will not use the report to discriminate.
4. **Before you turn someone down, warn them.** Send a copy of the report and the CFPB's "A Summary of Your Rights Under the Fair Credit Reporting Act." Federal law sets no waiting period, so give the person a real chance to point out errors. California's Fair Chance Act requires at least 5 business days, plus 5 more if the person says the report is wrong and is getting proof.
5. **After you decide, send the adverse action notice.** It gives the screening company's name, address, and phone number. It says the company did not make the decision and cannot explain it. It tells the person they may get a free copy of the report within 60 days and dispute anything in it ([15 U.S.C. 1681m](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title15-section1681m&num=0&edition=prelim)). The notice can be oral, written, or electronic, but a written one leaves proof.
6. **Store it, then destroy it properly.** Burn, pulverize, or shred paper, and wipe files so they cannot be read or rebuilt ([16 CFR 682.3](https://www.ecfr.gov/current/title-16/section-682.3)).

Reports built from interviews with the person's neighbors, friends, or associates about their character need an extra notice. The FTC's employer guide covers it.

Skipping the steps is expensive. A willful violation can cost the person's actual damages or $100 to $1,000, plus punitive damages and lawyer's fees ([15 U.S.C. 1681n](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title15-section1681n&num=0&edition=prelim)).

### What a screening company may report

| Record | Federal limit | California limit on investigative reports |
|---|---|---|
| Convictions | No time limit | None older than 7 years from disposition, release, or parole |
| Arrests without a conviction | 7 years, or the statute of limitations if longer | Not reported once no conviction resulted, except while the case is pending |
| Jobs paying $75,000 a year or more | The 7-year limits do not apply | No pay exception. The limits lift only where a government agency requires the employer to check those records. |

Federal limits are in [15 U.S.C. 1681c](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title15-section1681c&num=0&edition=prelim). California's are in Civil Code 1786.18. Broker look-back periods are separate and apply to your decision, not to the report.

## Using the results fairly

Apply the same checks and the same rules to every applicant for the same job. The EEOC and FTC guide on background checks (March 11, 2014) says it is illegal to decide whose background to check based on race, national origin, or another protected trait.

Federal enforcement shifted in 2026. On June 9, 2026, the Justice Department said its Office of Legal Counsel found the EEOC's disparate-impact guidelines under Title VII unconstitutional. Under that opinion, a criminal background check does not violate Title VII just because results differ between groups, and an employer need only show the practice is reasonable, useful, or serves a valid business purpose. State fair chance and anti-discrimination laws still apply.

California's Fair Chance Act, Government Code 12952, covers employers with five or more employees:

- No questions about convictions on the application or before a conditional job offer.
- No use of arrests that did not lead to a conviction, diversion programs, or sealed, dismissed, or expunged records.
- Before withdrawing an offer, an individualized look at the offense, the time since it, and the job.
- A written notice naming the convictions, with a copy of the report, and the response times in step 4 above.

The act does not apply where a state, federal, or local law requires the employer to run criminal checks. A broker contract is not a law, so the exception may not cover checks that only a broker requires. Ask a California employment lawyer before you rely on it. For which crimes bar which drivers, see can a felon be a NEMT driver.

## What NEMT driver background checks cost

Government fees, as of September 2026:

| Check | Cost | Paid to |
|---|---|---|
| National sex offender search (NSOPW.gov) | Free | Nobody |
| SAM.gov exclusion search | Free, no login | Nobody |
| Florida Level 1 statewide criminal search | $24, plus a $1 card fee for the instant online search | Florida Department of Law Enforcement |
| Florida Level 2 screening, new | $60 plus the fingerprint vendor's fee | The vendor, at the appointment |
| Florida Level 2 renewal, every 5 years | $42 | The Clearinghouse |
| Minnesota background study | Up to $44 per study | Minnesota Department of Human Services |

Screening companies set their own prices for national and county searches, and each state sets its own fee for driving records. Get a written quote that lists every search in your broker's definition, so you pay for what the broker actually requires.

## What to do when a check finds something

1. **Confirm it is the right person.** Name matches are common. For an OIG match, verify it in the online search with the person's Social Security number, which the downloadable file cannot do.
2. **Compare it with each program's rules.** Look up the offense, the date, and the look-back period in every contract and state rule you work under.
3. **Send the pre-adverse action notice** if you may turn the person down because of a screening company's report, and give the person time to respond.
4. **Stop at once on an exclusion match.** Take the person off all Medicaid work and bill nothing they provided. CMS asks states to require providers to report exclusions right away. If you already employed the person, OIG points to its Self-Disclosure Protocol. See the [OIG exclusion list](https://nemtguide.com/glossary/oig-exclusion-list/).
5. **Tell each broker** when the contract requires it, such as MTM Health's immediate notice rule.
6. **Write down the decision,** who made it, and why, and file it with the report.

## How to run NEMT driver background checks, step by step

1. **Collect the rules.** Pull the driver section of your state manual and every broker agreement. Build one checklist that meets the strictest rule in each row.
2. **Get signed forms first.** Use a stand-alone credit reporting disclosure with the authorization, any consent your state requires for the driving record, and any state form, such as Louisiana's consent to send results straight to the broker.
3. **Run the government searches yourself.** Search the OIG list, SAM.gov, your state exclusion list, and NSOPW.gov. Save a dated copy of each result.
4. **Pull the driving record** covering at least 3 years. See [motor vehicle record check](https://nemtguide.com/glossary/motor-vehicle-record/).
5. **Order the criminal check.** Match your broker's definition, or start the state program, such as Florida's Clearinghouse or Minnesota's NETStudy.
6. **Review and decide.** Send the notices before and after any decision based on a screening company's report.
7. **Credential with each broker.** MTM Health lets no driver work its trips until fully credentialed, and its Virginia handbook warns that trips by drivers with expired documents can lose payment.
8. **Put the reruns on a calendar.** Monthly exclusion searches, yearly criminal checks and driving records, and any state renewal dates.

Keep every result, consent form, and decision in the [driver qualification file](https://nemtguide.com/templates/nemt-driver-file-checklist/), and log monthly searches for all staff in one [exclusion screening log](https://nemtguide.com/templates/exclusion-screening-log/). Store reports apart from general personnel files, with limited access. Employers covered by federal discrimination law must keep hiring records for at least one year after the record is made or the hiring decision, whichever is later ([29 CFR 1602.14](https://www.ecfr.gov/current/title-29/section-1602.14)). Broker contracts can ask for more: MTM Health's standard contract asks for full records of your operations under it for 10 years. For the rest of the hiring process, see [how to hire NEMT drivers](https://nemtguide.com/guides/hire-nemt-drivers/).

## Frequently asked questions

### What background check do NEMT drivers need?

At a minimum, federal Medicaid law requires that no NEMT driver is on the HHS OIG exclusion list and that each holds a valid license. States and brokers add the rest. As of September 2026 that usually means a criminal history check, a sex offender registry search, a driving record covering at least 3 years, and searches of SAM.gov and your state exclusion list, all finished before the first ride. MTM Health's standard contract also names a Social Security number trace and county court searches.

### How far back does a NEMT background check go?

It depends on the report and the contract. Under the federal Fair Credit Reporting Act, a screening company may report convictions of any age, but arrests that did not lead to a conviction generally drop off after 7 years for jobs paying under $75,000. California bars investigative reports on convictions more than 7 years old. Brokers set their own look-back periods: 7 years for felonies under MTM Health's standard contract, 5 years in Georgia, and 10 years at MTM Health in Rhode Island.

### How often do NEMT drivers need a new background check?

Every year under many contracts, with monthly exclusion searches in between. MTM Health's standard contract (January 1, 2023) and its Rhode Island handbook (July 1, 2026) call for a criminal check before hire and every year, and Louisiana requires one every year. Texas health plans recheck sex offender registries every year and the OIG and SAM.gov lists every month. CMS asked states in 2009 to require monthly OIG searches.

### Do NEMT drivers need a fingerprint background check?

Only where a state or broker requires one. Minnesota requires a state background study with fingerprints for every driver. Florida requires a name-based Level 1 check for drivers and a fingerprint-based Level 2 check for owners and managers. Louisiana wants a yearly check run by the State Police, an agency it authorizes, or the FBI, with results sent straight to the broker. Elsewhere, ask each broker whether a name-based check from a screening company meets its definition.

### Can I run a background check on a 1099 driver?

Yes, and the same credit reporting steps apply. FTC staff read "employment purposes" broadly enough to cover people who are not technically employees, such as truck drivers who own and run their own trucks. Give the stand-alone disclosure, get written permission, and send the adverse action notices as you would for an employee. Brokers apply their rules to every driver too: MTM Health's contract defines a driver as anyone the provider directly retains or employs.

### Do owners of a NEMT company need a background check?

Yes. An owner who drives needs the same driver file as any employee under MTM Health's standard contract. Owners are also checked through Medicaid enrollment. States search owners and managing employees on the OIG and SAM.gov lists at least monthly (42 CFR 455.436). Florida requires a fingerprint-based Level 2 screening of every owner of 5 percent or more, officer, and managing employee, and Minnesota requires background studies of owners of 5 percent or more.

### Can I hire a NEMT driver with a criminal record?

Sometimes. Start with each program's list. MTM Health's standard contract bars any sexual or violent crime and allows a felony from the last 7 years only with its client's approval. Georgia allows a felony from the last 5 years only after the broker and the state review it. Texas health plans bar any conviction for abuse, neglect, or exploitation of children, older people, or people with disabilities, however old. For records no rule lists, apply the same standard to every applicant and follow your state's fair chance law.

## Official resources

- [HHS OIG: Search the exclusion list (LEIE)](https://exclusions.oig.hhs.gov/)
- [SAM.gov: Search federal exclusions](https://sam.gov/search/?index=ex)
- [U.S. Department of Justice: National Sex Offender Public Website (NSOPW)](https://www.nsopw.gov/)
- [FTC: What employers must do before and after a background check](https://www.ftc.gov/business-guidance/resources/using-consumer-reports-what-employers-need-know)
- [CFPB: A Summary of Your Rights Under the Fair Credit Reporting Act (send with every pre-adverse action notice)](https://files.consumerfinance.gov/f/documents/bcfp_consumer-rights-summary_2018-09.pdf)
- [Florida Care Provider Background Screening Clearinghouse](https://info.flclearinghouse.com/faq.html)
- [Texas DPS: Criminal history conviction name search](https://publicsite.dps.texas.gov/ConvictionNameSearch/)