MedicaidAdministrativeMedium impact
Provider Notification - Criminal Background Screening Policy
Aetna Better Health of Virginia·VA·Policy Update
Effective date
May 1, 2025
We identified it
Aug 13, 2026
Summary
Aetna has implemented a new criminal background screening policy requiring all Aetna providers to conduct criminal background checks on employees before hire and every three years thereafter. Providers must maintain documentation, disclose the process to employees, provide records to Aetna annually, and comply with annual audits. This is an operational/compliance requirement, not a clinical or billing code change.
Action Required
By May 1, 2025: Provider administrative staff (not billing team directly) must implement criminal background screening procedures for all employees. Billing team should be aware that: (1) Provider compliance with this policy is a condition of Aetna contract maintenance, (2) Non-compliance could result in contract sanctions affecting the entire practice's ability to bill Aetna, (3) Providers must establish documentation systems to track screening dates and results. HR/Administrative leadership must ensure criminal background checks are conducted for all current employees by the policy start date and schedule recurring checks every three years. Maintain all screening records for annual submission to Aetna upon request and prepare for annual Aetna audits. Failure to comply may result in contract termination and claims payment suspension.