Wintry mix spreads across Minnesota

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State of Minnesota officials said they are making progress in their effort to revalidate nearly 5,600 medical care providers across the state amid federal accusations of widespread fraud in the program that provides health insurance coverage to low income residents.  

 in Medicaid funding to the state, and it is threatening to withhold 

 over fraud concerns. Last month, the federal Centers for Medicare and Medicaid Services approved the state’s corrective action plan,

 a decision called “encouraging” by state officials.

Nonetheless, the federal Centers for Medicare and Medicaid Services has refused to release the money, and a federal judge this week 

the Trump administration from continuing to withhold funds. 

In a briefing Thursday, Minnesota Medicaid director John Connolly said the decision was disappointing, but the corrective action plan is underway. The state is evaluating a total of 5,583 Medicaid providers in the 13 service areas that have been determined as having a high-risk of fraud. That includes checking their licenses and conducting unannounced inspections. 

So far, 550 health care providers have completed the process and have been approved. About 2,500 providers — a little less than half — have not responded yet or have incomplete applications. And 160 have been disenrolled — Connolly said most of them were inactive. 

“We're approaching disenrollment much more aggressively than we have in the past, but it's imperative that we meet the federal government's requirement to execute this corrective action plan,” he said.

Late last year, then-U.S. Attorney Joe Thompson 

 in fraud had been committed by Minnesota Medicaid providers, but he provided no evidence to back up the figure and 

 have said they don’t know how it was reached. 

“We don't yet have a number, so we don't know that to be true, and numbers that are placed out there at this point are speculative, because investigations are continuing,” Connolly told reporters in February. 

He added Thursday that, so far, inspections of Medicaid providers haven’t found evidence of widespread fraud. 

“We're finding providers doing the work that they said they would do, and of course, operating as they stated in their paperwork,” he said. “That is the vast majority of providers in the program, and what we found to date in the site visits.”

Connolly added it is critically important that the federal government restore the funding as soon as possible. 

“More than 20 percent of Minnesota's population relies on Medicaid for life-saving and life-affirming health care services,” Connolly told reporters Thursday. “We have to ensure we secure the funding for those necessary services.”

The state should complete the revalidation process by the end of May, Connolly said. But it's not clear when the federal government will release the money and how much future funding will be withheld.  

“(Centers for Medicare and Medicaid Services) Administrator (Mehmet) Oz and the vice president signaled that they could very possibly do this again in future quarters, in which case we would have another set of deferrals and another set of documentation requests,” he said. “So, this could go on for many quarters.”

Connolly said despite the potential funding shortfall, there won’t be an immediate impact on the services themselves or revalidated providers. 

“At some point in the future, should there be a financial or cash flow impact of the state as a result of these actions, it would take an action of the legislature to to stop financing or to stop including that service or benefit in the program,” Connolly said.

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Fraud in Minnesota

Harshawn Ratanpal

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State officials say that about 10 percent of Minnesota’s Medicaid health care providers in 13 high-risk programs have been evaluated and revalidated thus far as part of its corrective action plan to address allegations of Medicaid fraud.

Minnesota’s plan to fight fraud underway as federal Medicaid money remains frozen

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