MN Medicaid providers in limbo after rapid revalidation process
Families face uncertainty as Medicaid service providers lose fundign
Families are facing uncertainty as Minnesota Medicaid providers are losing funding. FOX 9's Corin Hoggard has more.
MINNESOTA (FOX 9) - Thousands of Minnesota Medicaid providers are still stuck in purgatory because of the rapid revalidation process the state had to carry out this year.
READ MORE: Minnesota Medicaid revalidation: Families of disabled adults fear losing services
Providers appeal Medicaid rapid revalidation
Medicaid service providers looking for answers
Throughout Minnesota roughly 3,400 Medicaid service providers are trying to prove the legitimacy of their services after the state disenrolled roughly 60% of its providers. FOX 9’s Corin Hoggard has the details.
Big picture view:
There are about 2,200 providers appealing after the got disenrolled last month during the rapid revalidation process.
The state is now allowing providers who have appealed to resume billing for their services, but it cut them off initially.
This state of limbo created an uncomfortable situation for a lot of patients and a dangerous one for several.
READ MORE: Minnesota fraud: State DHS commissioner testifies before Congress
MN Medicaid deadline: Providers see funding cutoff
A rushed Medicaid review has left thousands of Minnesota care providers suddenly without funding, putting essential services, vulnerable patients, and jobs at risk. The sudden Medicaid cutoff comes after the federal government withheld $2 billion over fraud concerns, forcing the state to evaluate about 5,500 providers in high-risk programs in just five months.
What they're saying:
Tricia Brisbine, from Family Voices of Minnesota, said, "There was one adult with significant disabilities that has been without essential in-home services for more than a month. The resulting unmet care needs contributed to a medical crisis that ultimately required a week-long stay in the intensive care unit."
Providers who appealed say they're happy they can bill again, but they’re struggling with other restrictions, like adding staff.
READ MORE: MN fraud: Minnesota DHS notifies 3,400+ Medicaid providers that they are facing removal
Why you should care:
The Human Services Department got a mandate from the federal government to make sure about 5,600 providers in high-risk programs were actually doing the work.
They had five months for a process that usually takes two years.
They acknowledge it hasn’t been perfect.
They’ve gotten through fewer than 400 appeals in the last month.
The backstory:
Since January, the state has gone through the process of revalidating 5,583 Medicaid providers in "high-risk programs." Providers were required to provide the information they gave when they first became providers. The state says they made multiple attempts to contact each provider, including three written attempts and multiple follow-up calls.
Providers had to provide basic ownership disclosures, current licenses, prove they had enough workers, and provide fingerprints for owners. The state would also conduct unannounced site visits at the facilities.
The effort came as the state was under fire from the federal government over its oversight of the state's Medicaid program for fraud.
The Source: This story uses information gathered by FOX 9 reporter Corin Hoggard and previous FOX 9 reporting.