Medicaid anti‑fraud approved
Federal approval of Minnesota’s Medicaid anti‑fraud plan signals increased scrutiny on documentation and compliance for businesses involved in public or subsidized projects. Contractors working on any government‑funded work should expect tighter records and audit readiness going forward. (twincities.com)
In a Thursday letter, the Centers for Medicare and Medicaid Services told Minnesota that the state’s corrective action plan was “deemed sufficient,” noting the plan was submitted on Jan. 30 and that CMS recognized Minnesota met its Feb. 1 and Mar. 1 goals before approval. (mprnews.org) CMS had deferred $259,505,491 in federal Medicaid matching funds tied to Minnesota’s fourth quarter FY2025 expenditures, including $243.8 million CMS flagged as unsupported or potentially fraudulent claims and $15.4 million tied to claims involving individuals lacking satisfactory immigration status. (natlawreview.com) Minnesota Department of Human Services officials cited CMS Administrator Mehmet Oz’s prior public statement that CMS would release about $243 million in deferred funding once the state “proposes and acts on a comprehensive corrective action plan.” (mprnews.org) CMS’s letter says the corrective action program will include a revalidation process for high‑risk service providers that the agency expects to be completed by the end of May. (mprnews.org) The State of Minnesota filed a federal lawsuit on March 2, 2026, seeking immediate relief to restore suspended Medicaid payments, and Minnesota attorneys later told the court they were seeking further clarification from CMS about next steps; CMS indicated it would ask the state to pause the lawsuit. (natlawreview.com) (mprnews.org) A March 17 Office of the Legislative Auditor special review found Early Intensive Developmental and Behavioral Intervention (EIDBI) program costs rose from $38.1 million in 2020 to $324.9 million in 2024, with recipients increasing from about 1,400 to 5,600 and providers more than tripling. (auditor.leg.state.mn.us) The federal approval in Minnesota comes amid a broader CMS anti‑fraud push announced Feb. 25 that includes a six‑month nationwide moratorium on new enrollments for certain DMEPOS suppliers and heightened scrutiny of other states such as California, Florida, Maine and New York. (hhs.gov) (kff.org)
