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Looking at Minnesota autism fraud scheme
Moderator Blois Olson joins FOX 9 All Day to discuss the latest multimillion-dollar fraud scheme uncovered in Minnesota, which targets the state?s autism program.
(FOX 9) - A letter signed by Dr. Mehmet Oz on behalf of the Centers for Medicare and Medicaid Services (CMS) says the agency is "increasingly concerned with the performance and integrity of Minnesota’s Medicaid program" that require immediate action, or the state’s federal Medicaid funding could be withheld from programs expected of fraud.
Minnesota fraud
What we know:
Following allegations of fraud, Gov. Walz initiated payment stoppage to providers in 14 state programs in October while an outside auditor analyzed Medicaid claims.
Fraud found in cases so far total roughly $24 million across two Medicaid programs: An estimated $10 million tied to housing services, and $14 million involving autism therapy for children.
According to data provided by the Minnesota Department of Human Services (DHS), those cases represent two of several programs in which fraud has been found, in addition to several still under review for people with disabilities, child-care assistance and mental health service needs.
Minnesota mandates
Dig deeper:
The letter states that Minnesota’s DHS will now be required to provide CMS with weekly updates on the state’s audit activities regarding the previously mentioned 14 state programs.
It also states that DHS should institute an immediate pause, or moratorium, on any new provider enrollments for the 14 programs until state officials can "demonstrate corrective progress and improved oversight." If the state fails to do so, CMS will initiate a federal moratorium as a result.
By the end of December, CMS is also requesting a comprehensive corrective action plan outlining timelines and measures that DHS plans to implement.
Should DHS fail to provide any of the requirements by the end of January 2026, the letter states that "CMS may initiate actions to withhold federal Medicaid funding" for expenditures stemming from the 14 programs, while noting that a "far more aggressive approach is required to protect taxpayers – and Medicaid enrollees."