NPPs get hired without licenses, despite exclusion; keep your guard up

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This practice management article examines hiring and credentialing risks for clinical staff, especially nonphysician practitioners, through the lens of a fraud case involving an improperly credentialed physician assistant. It covers general compliance checks such as license verification, exclusion screening, background review, and state-level licensure considerations, and it is relevant to practice managers, compliance staff, and healthcare administrators.

Why This Topic Matters

Hiring or retaining unqualified or excluded clinical staff can expose a practice to fraud, repayment, legal, and patient-safety risks. The article helps readers understand the importance of ongoing credential verification and compliance screening.

Article Sections

  1. Practice management

    Introduces the compliance and hiring risks associated with clinical staffing. It frames the broader administrative concerns raised by the case example.

  2. Don’t trust, verify

    Discusses the need for credential verification and ongoing oversight during hiring and employment. It also addresses the pressures that can make vetting more difficult in today’s workforce environment.

  3. Not just the license

    Covers additional screening and compliance checks beyond basic licensure, including background review, exclusion screening, and state-level practice requirements.

What You Will Learn

  • Why credential and license verification matters in clinical hiring
  • What broader compliance checks are commonly discussed for healthcare personnel
  • How workforce shortages can increase hiring and oversight risks
  • Why exclusion screening and background review are important in practice operations
  • How state-level licensure and collaboration requirements may affect clinical staffing

Who Should Read This

  • Practice managers
  • Compliance officers
  • Healthcare administrators
  • Billing staff
  • Physician practices
  • Nursing leadership

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