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Partners,
We know many of you are closely tracking the rapidly evolving federal activity impacting programs administered by the Minnesota Department of Human Services. We recognize these actions create uncertainty and questions for you and the individuals you serve. We appreciate and value your partnership as we navigate these challenges while continuing to serve Minnesotans.
The Department of Human Services has formally appealed and requested a hearing on the decision by the Trump Administration to withhold over $2 billion in annual Medicaid funding for Minnesota. The loss of this funding would be significant for our state. We know this threat has caused extra confusion about what it means for the services many of you provide.
It is important for everyone to know that there have been no changes to funding at this time. Providers should continue to bill as usual. You will continue to be paid for eligible services you provide Medicaid enrollees under state law.
Since October 2024, the Minnesota Department of Human Services has enhanced its continued work to stop fraud in Medicaid programs, identify risks, and harden programs to prevent bad actors from accessing them. That work is ongoing, but to-date actions include:
- Identifying 14 high-risk services and establishing a program integrity dashboard for the public.
- Auditing autism service providers, including on-site visits.
- Discontinuing the Housing Stabilization Services benefit.
- Establishing a moratorium on adding new service providers in the remaining 13 high-risk services.
- Beginning enhanced pre-payment review before fee-for-service payments are made to providers in the 14 high-risk services.
- Developing plans to review and revalidate providers in the remaining 13 high-risk services.
The state acted to meet or exceed the steps CMS requested in a December letter to address program integrity concerns. However, CMS Administrator Dr. Mehmet Oz deemed the Minnesota Department of Human Services’ actions inadequate — without time for state and federal agencies to discuss and agree upon a corrective action plan.
Eliminating fraud remains a top priority for the agency. Members of the department’s leadership team met with Administrator Oz and other officials from CMS recently, and we continue to work diligently to propose solutions and partner with CMS in good faith.
Find details and updates on the Minnesota Department of Human Services’ program integrity work at Medicaid program integrity webpage.
The department also launched a new e-newsletter for providers titled MHCP Provider Connect: A weekly roundup of news, updates and reminders to keep Minnesota Health Care Programs providers informed of developments at the Minnesota Department of Human Services.
We will continue to monitor developments and update as we can.
Thank you for the critical work you do on behalf of Minnesotans.
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