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Minnesota DHS defends Medicaid fraud crackdown
In an opening statement, Minnesota Department of Human Services temporary commissioner John Connolly defended the state's Medicaid fraud prevention efforts before Congress, highlighting thousands of investigations, millions of dollars recovered and expanded oversight while warning against disruptions to Medicaid funding.
ST. PAUL, Minn. (FOX 9) - The Minnesota Department of Human Services is extending its pause on accepting new providers for 12 high-risk Medicaid programs as it continues its efforts to combat fraud.
Medcaid pause continues
What we know:
The Minnesota Department of Human Services says it will continue the pause on new providers for at least another six months.
This pause does not include a two-year pause on adult day centers that was issued in February and the pause on licensing for new Home and Community-Based Services that runs through 2027. This pause also doesn't affect a pause on new enrollments in the Early Intensive Development Behavioral Interventional program that runs through October.
What they're saying:
In a provided statement, temporary Department of Human Services Commissioner John Connolly writes: "We still have a lot of work to do to verify the providers we have before we begin accepting new applications. We’re working closely with providers, counties and managed care organizations to make sure people who rely on Medicaid services in these areas have access to care. If necessary, we can make exceptions to the moratorium."
Minnesota battle with feds over Medicaid funds
Local perspective:
The pause was first issued in January as the state launched a revalidation effort to check more than 5,500 Medicaid providers in the state. The deadline for the revalidation passed at the end of May, leaving more than 3,400 providers disenrolled.
But, despite the fact the state disenrolled thousands of providers, only 59 were referred to the Office of the Inspector General – which would investigate potential fraud.
As of July 13, DHS says nearly 2,700 providers have appealed their decision.
Big picture view:
The revalidation effort was launched as the state battled with the federal government over $2 billion in Medicaid funding that was pulled.
Attorney General Keith Ellison filed a lawsuit against the Trump administration over the pulled funds earlier this year. In May, a judge granted a mutual request for a pause in the lawsuit so the state and feds could try and work out a deal.
An update in the case is due by September.