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Minnesota Medicaid fraud crackdown underway
Minnesota will now be taking more steps to crackdown on widespread Medicaid fraud. FOX 9’s Mike Manzoni explains the changes ahead.
MINNEAPOLIS (FOX 9) - The Minnesota Department of Human Services has launched a fact-checking website aimed at addressing what officials describe as misleading and false claims about Medicaid fraud in the state.
Fact-checking fraud in Minnesota
The backstory:
The website says it’s a place where Minnesotans can find "accurate information about our fight against fraud" and intends to correct false claims and exaggerated figures circulating online. The initial round of fact checks address inflated estimates of Medicaid fraud, the alleged findings of fraud circulating in social media videos, among other issues.
"Speculation, intentional misinformation and amateur investigations will not stop fraud in our state. It takes hard evidence to put criminals behind bars," said Temporary Human Services Commissioner Shireen Gandhi. "While we continue to tighten oversight, we’re also making sure people have a place to go for facts when they hear claims that are intended to justify the defunding of social services programs."
Dig deeper:
The fact-check page is part of the state’s broader Medicaid program integrity website, which includes additional information and resources about fraud prevention efforts.
Since fall 2024, the department says it has implemented new processes to detect and prevent fraud, including identifying high-risk services, auditing providers, and enhancing pre-payment reviews. Gov. Tim Walz also ordered a third-party audit of Medicaid billing. The findings released in February identified more than $1 billion in Medicaid funding that may be vulnerable to waste, fraud and abuse.
The audit follows the U.S. Attorney's Office filing charges in a massive Minnesota Housing Stabilization program fraud scheme and a scheme targeting a state program to help those on the autism spectrum.
Both fraud cases come on the heels of the massive investigation and criminal case into Feeding Our Future, an organization that bilked more than $250 million from a USDA and Minnesota Department of Education program to feed school children during the COVID-19 pandemic. The investigation into Feeding Our Future led federal prosecutors to uncover some of the other fraud.
By the numbers:
The fact-check website cast doubt on some estimates of the size of the Medicaid fraud in Minnesota.
The website includes a quote from President Trump that puts the size of the fraud at greater than $19 billion. The quote reads: "In Minnesota they think [fraud is] $19 billion…triple it, quadruple it!"
The fact check downplays President Trump's estimate as a political attack and states that "speculation is not fraud." The fact check goes onto point out that the known fraud from prosecuted criminal cases stands at about $217 million.
But, while President Trump's figures may be inflated, it's worth noting that estimates of fraud numbering in the billions of dollars aren't completely fabricated. That figure first came from former Assistant U.S. Attorney Joe Thompson.
In December, while announcing new fraud charges, Thompson said it was entirely possible that as much as half or more of the $18 billion in funds paid out to 14 high-risk Medicaid programs in Minnesota may have been fraudulent.
"I don't make these generalizations in a hasty way," said Thompson. "So, when I say a significant amount, I'm talking in an order of half or more. But we'll see. When I look at the claims data and the providers, I see more red flags than I see legitimate providers and overwhelmingly so."
Thompson was the lead prosecutor in the massive Feeding Our Future fraud case and a top prosecutor in the U.S. Attorney's Office before he was among the prosecutors who resigned last month, reportedly over grievances with how the office was handling the shooting of Renee Good. Just Tuesday, Thompson, now a private attorney, was hired to represent Don Lemon in his case over the anti-ICE protest at a St. Paul church.
The Source: This story uses previous FOX 9 reporting and information from a Minnesota DHS press release.