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3,400 Minnesota Medicaid providers disenrolled as a part of a an effort to secure billions in federal aid

3D illustration of private investigator files with the words investigation and fraud
Fraud
Olivier Le Moal/Getty Images

Over 3,400 Minnesota Medicaid providers have been disenrolled as a part of a an effort to secure billions in federal aid.


This comes amid a federally mandated review that found incomplete paperwork, missed site visits, or failed background checks for the majority of applicants.

While state officials say the sweep as a necessary step to protect taxpayer funds and get back federal aid that is currently frozen, advocacy groups warn that the massive disruption could leave vulnerable patients struggling to find replacement care.

“More than 1 million Minnesotans deserve to have confidence and trust in the Medicaid providers they depend on for lifesaving and life-affirming care,” said Deputy Commissioner Shireen Gandhi. “We are grateful to the providers who successfully completed the revalidation process and will continue to provide quality care.”

The Minnesota Department of Human Services finished a comprehensive top-to-bottom review of nearly 5,600 high-risk Medicaid providers on time on May 31. Completing the effort is a key part of Minnesota’s plan to stop the federal government from withholding up to $2 billion from its Medicaid program.

The five-month review required providers to show they met heightened legal and eligibility standards required to operate and serve vulnerable people.

In April, the Trump administration notified Minnesota that it's deferring an additional $91 million in Medicaid funding, due to fresh concerns about vulnerabilities to fraud in state-run but federally funded social service programs.

“Minnesota state-run programs have raised serious red flags,” Dr. Mehmet Oz, administrator for the Centers for Medicare and Medicaid Services, said in a video statement on social media.

Moving forward, the state is conducting weekly meetings with local organizations to track the more than 800 providers who have filed to appeal the states decision to disenroll them.

Of the 5,583 high-risk providers required to revalidate:

  • 2,061 were revalidated and are continuing to provide Medicaid services without interruption.
  • 3,411 were notified they will be disenrolled:
    • 2,491 were due to submissions of incomplete paperwork and documentation.
    • 916 were due to failed verification at site visits.
    • 4 were due to failed background study.
  • 111 were removed from review at this time because they are no longer providing a high-risk service.
  • 59 were referred to the department’s Office of Inspector General for further review.

“The paperwork is a critical step,” said Gandhi. “This is just not checking the box. DHS uses the information to check requirements are met. And when we go on site what we see must match what was submitted to us.”