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Medicaid Program Integrity Update  -  February 2026

“Fraud perpetrated against the State is unacceptable and my administration will not tolerate the abuse or misuse of public funds.”

Governor Tim Walz, Executive Order 25-10 (PDF)

A deep dive into Minnesota’s fight against fraud 

We're excited to share our efforts around fighting fraud, waste and abuse. Anyone can sign up to receive this newsletter by visiting our Medicaid Program Integrity website, which also has has more about efforts to meet the 16 directives in the Governor’s Executive Order (PDF) to fight fraud.

Fact check: Fraud truth vs. fiction Accurate, fact-based information is critical in the fight against fraud. Our new Fact Check webpage corrects misleading information and outright false claims about Medicaid fraud in Minnesota.  Our first “checks” address the ever-growing and exaggerated fraud totals, a YouTube investigator’s false claims, and the $2 billion dollars in Medicaid being withheld by the federal government. The site will be updated on an ongoing basis. Learn more in our news release.

Minnesota to make on-site visits to 5,800 providers; appeals federal decision to withhold $2 billion 

We are bringing in 168 staff from across state agencies to help with the unprecedented revalidation of over 5,800 high-risk Medicaid providers by summer. This is a cornerstone of the state’s efforts to convince the federal Centers for Medicare & Medicaid Services (CMS) to reverse course on a highly unusual action to withhold over $2 billion in annual Medicaid funding. We are also appealing that decision.

Federal report: Minnesota's improper payment rate is well below national average  

Federal CMS data released in January 2026 shows the overall rate of improper payments in Minnesota’s Medicaid program is well below the national average when compared to other states.  Minnesota’s error rate is just over 2.1%, compared to a national average of 6.1%. Reviewers at CMS checked billing statements and then compared them with medical records to ensure the billing was accurate.

Meet Inspector General James Clark

The Office of Inspector General ensures the integrity of human services including identifying and preventing fraud, waste and abuse; licensing providers; and conducting background studies. Inspector General James Clark has extensive legal and investigative experience, including nearly a decade at the Minnesota Attorney General’s Office representing MN DHS, prosecuting Medicaid fraud, and leading complex financial investigations.

By the numbers: Investigations  

In 2025, we opened a record-high number of cases and imposed more than twice as many payment withholds as we did in other recent years. Since 2020, we have conducted over 3,000 investigations, referred over 500 cases to law enforcement and identified more than $50 million for recovery. Every $1 spent on investigators = $2.29 in monetary recovery and cost avoidance. Find more data on our website.

'Fraud tourists' plead guilty

We work with our law enforcement partners to hold criminals accountable for their actions. Two Pennsylvania residents charged with defrauding Minnesota Medicaid’s Housing Stabilization Services pleaded guilty Feb. 9 in federal court. The two were charged with bilking the program of $3.5 million.  In summer 2025, the state suspended payments to these providers and referred the case to law enforcement. Since then, we discontinued the Housing Stabilization Services benefit and implemented several new verification checks to prevent fraud in other services.

Prosecution actions

Attorney General Ellison announces over $3 million in fraud charges against Medicaid provider  Attorney General Ellison partners with federal law enforcement on indictments of Housing Stabilization Services and Early Intensive Developmental and Behavioral Intervention providers  U.S. Attorney: Six additional defendants charged, one defendant pleads guilty in ongoing fraud schemes

News release roundup

Minnesota kicks off big push to inspect Medicaid providers​​  Federal review determines rate of improper payments in Minnesota’s Medicaid program is far below national average  Minnesota Department of Human Services to freeze provider enrollment for 13 Medicaid services  Licensing pause extended to adult day care settings  New licensing pause will improve oversight of home and community-based human services in Minnesota

Suspect fraud or abuse?  

MN DHS strongly encourages anyone with information about suspected Medicaid fraud to contact us by calling 651-431-2650 (1-800-657-3750) or submitting a report online. 

You can also report suspected fraud to the Minnesota Bureau of Criminal Apprehension’s Financial Crimes and Fraud Section, which provides additional safeguards to protect whistleblowers.

Accessible formats

For accessible formats of this publication, write to dhs.communications@state.mn.us, or call 651-431-2000 or use your preferred relay service.