Overview
- DHS is recruiting 168 state employees for unannounced site visits and document checks to revalidate roughly 5,800 providers in 13 high‑risk programs, with training starting this month and inspections to follow.
- December’s prepayment review halted reimbursements for 14 high‑risk services, triggering cash‑flow disruptions for providers, with most delayed payments restored on Jan. 27.
- Optum is reviewing about 100,000 claims every two weeks; more than 70 were denied to date, and none have been flagged as fraudulent, according to DHS.
- Federal officials rejected Minnesota’s initial corrective action plan and warned up to $2 billion could be withheld, and the state has appealed and submitted revisions that could take up to 60 days to review.
- DHS closed the Housing Stabilization Services program and began disenrolling inactive providers, as federal data put Minnesota’s Medicaid improper payment rate at 2.1% compared with 6.1% nationally.