The Governor and DHS Commissioner Shireen Gandhi are unveiling a plan to shift Medicaid administration away from a county-led model to a centralized state system following several high-profile fraud cases.
Walz says 45 percent of Medicaid spending and 80 percent of basic care are administered through eight Managed Care Organizations and one of the key changes would be shifting eligibility determination from counties to the state in 2028. Adding that the system has grown too complex for the necessary oversight.
He went on to say the proposal aims to replace outdated technology and streamline eligibility processes.
“ It has been difficult and especially for the counties to be able to administer those correctly,” says Walz, “ And so when it comes down to it I would tell you it is both the complexity of it and you’ve seen the other pieces of this outdated technology, the Maxus system is grossly outdated.”
The governor pushed back on the idea that the plan would mean job losses for county workers, and said instead the plan is meant to equip them with the proper tools to do their jobs.
“We think this is a way of simplification, it's a way to use best practices. It's a way to use modern technology, It's a way to use AI.” says Walz “ And what that does is takes the burden off the counties.”
The plan comes as the federal government is withholding $259 million in Medicaid funding until the state lays out a plan to fight fraud.
Republican lawmakers criticized the plan, arguing that expanding an already distrusted state agency at the expense of private sector partners will increase taxpayer costs.
The two sides must now negotiate the details of the plan as the legislature weighs the issue.
