In response to a Congressional request, the OIG has reviewed the extent to which home health agencies (HHAs) have employed individuals with criminal convictions and whether state requirements should have disqualified such individuals from HHA employment. The OIG points out that there are no federal requirements that HHAs conduct background checks on employees, and state requirements vary. The OIG conducted an analysis of a sample of Medicare-certified HHAs and the individuals they employed as of January 1, 2014. All HHAs reviewed conducted background checks of varying types on their prospective employees, and about half also conducted periodic rechecks after hiring. The OIG found that 4% of HHA employees had at least one criminal conviction, FBI criminal history records were not detailed enough to enable the OIG to determine whether all of the employees should have been disqualified. The OIG recommend that CMS promote minimum standards in HHA employee background check procedures by encouraging more states to participate in the National Background Check Program; CMS concurred.