Heavily-redacted audit finds Minnesota Medicaid had widespread vulnerabilities
A state-commissioned review of Minnesota’s Medicaid program uncovered sweeping financial vulnerabilities across 14 high-risk service areas, finding systemic weaknesses that allowed questionable billing to go undetected and estimating that clearer...
By Fox News · Fox News
A state-commissioned review of Minnesota’s Medicaid program uncovered sweeping financial vulnerabilities across 14 high-risk service areas, finding systemic weaknesses that allowed questionable billing to go undetected and estimating that clearer policies and stronger pre-payment safeguards could save taxpayers more than $1 billion. A vulnerability assessment by Optum State Government Solutions analyzed nearly four years of claims data, identifying widespread financial risks and specific weaknesses in 14 high-risk service areas — including housing stabilization and personal care assistance. While more than a dozen high-risk areas were identified, the actual descriptions of the vulnerabilities found within each program are redacted, along with references to "recurring vulnerabilities" that appeared across nearly all services. GOP SENATORS LAUNCH TASK FORCE TO CRACK DOWN ON FRAUD TIED TO MINNESOTA SCANDAL The high-risk service and program areas identified, in order of priority, are: 1. Housing Stabilization Services (HSS) 2. Peer Recovery Support Services (PRSS) 3. Early Intensive Developmental and Behavioral Intervention (EIDBI) 4. Integrated Community Supports (ICS) (Home and Community Based Service) 5. Non-Emergency Medical Transportation (NEMT) 6. Adult Rehabilitative Mental Health Services (ARMHS) GOP SENATOR PUSHES TO CREATE ANTI-FRAUD SPECIAL INSPECTOR GENERAL AFTER MINNESOTA FRAUD REVELATIONS 7. Personal Care Assistance (PCA) / Community First Services and Supports (CFSS) 8. Adult Day Services (ADS) 9. Recuperative Care (RS) 10. Individualized Home Supports (IHS) (covers services without training, with training, and with family training) 11. Adult Companion Care (ACC) 12. Night Supervision (NS) 13. Assertive Community Treatment (ACT) 14. Intensive Residential Treatment Service (IRTS) The report also withholds specific "tactical issues" and methods related to how claims are adjudicated and audited. A notice at the beginning of the document states it contains "…