Minnesota
Minnesota House Minority Leader Furious Over New Reports Surrounding Medical Assistance Fraud Allegations at Autism Centers
(KNSI) — More fraud allegations have surfaced in Minnesota, this time with certain autism service providers.
The Department of Human Services is looking into more than a dozen autism centers due to potential Medicaid fraud, according to the Minnesota Reformer. The Reformer reported in June the FBI is investigating the allegations.
Reports show that the number of providers has increased by 700% in the last five years, and payments to those providers have exploded by 3,000%.
House Minority Leader Representative Lisa Demuth (R-Cold Spring) has been hammering the Walz administration for fraud, which she says he has allowed to run rampant. She cites especially the Feeding Our Future case, in which 70 individuals are accused of bilking the U.S. Department of Agriculture’s Child Nutrition Programs out of $250 million.
A press release from Demuth’s office says sources who administer Medical Assistance see widespread concern about fraud in the program. MA is a state and federal health plan for low income residents and residents with disabilities. The Reformer’s article cited DHS Assistant Commissioner Natasha Merz, who described the growth as “pretty consistent” with other DHS programs. Merz added, “I don’t think we are surprised or particularly disturbed by the rate of growth. Anytime we’re operating Medicaid programs, we have to ensure we’re good stewards of taxpayer money, and that we have the right level of protections in place against fraud, waste and abuse.”
Demuth is infuriated by the article and the silence from the top down about the investigation, which Governor Tim Walz told the Star Tribune he was not aware of.
“It’s troubling that we are only learning about these developments through the media and have not received any information from the Department of Human Services, especially when there are two sitting DFL legislators directly connected to this program and the DHS investigative unit,” said Demuth. “There have also been shifting explanations by DHS – two weeks ago an Assistant Commissioner stated that DHS was not “surprised or particularly disturbed” by the rate of growth. Now today we learn that DHS is actively investigating this potentially fraud-riddled program. Which is it? When did these investigations begin? Democrats should be holding hearings and demanding answers rather than continuing to make excuses for the Walz administration’s failure to prevent fraud and hold those who enable it accountable.”
Autism centers are not licensed by the state. Providers sign up to get reimbursements through MA, and the DHS then verifies the center’s credentials, but are not out fact checking the centers in person. It’s similar to how the Feeding Our Future fraud was allowed to continue. According to an audit, the Minnesota Department of Education, which oversaw the USDA’s two child nutrition programs, did not conduct monitoring visits and compliance reviews at feeding sites, either didn’t follow up on complaints about Feeding Our Future or conducted inadequate investigations.
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ST. PAUL, Minn. (FOX 9) – Sunday was the deadline for Minnesota to complete the revalidation of thousands of Medicaid providers in “high-risk” programs as the state fights with the federal government over about $2 billion in funding.
What is Minnesota Revalidate?
The backstory:
Earlier this year, state leaders announced an effort to revalidate more than 5,500 providers in Minnesota’s Health Care Programs. The revalidation was part of an effort to combat fraud and to satisfy demands from the federal Centers for Medicare and Medicaid Services, which has withheld up to $2 billion in Medicaid funds from Minnesota.
The deadline to finish the revalidation was on Sunday, May 31.
What we know:
As of last month, state officials said only 550 providers have had applications approved, site inspections completed and been re-enrolled.
At that point, 1,510 applications were incomplete, and 160 providers had been disenrolled. State officials said mostly because they had failed to respond to state inquiries.
There were an additional 990 who had been submitting claims but failed to respond to state notices.
Medicaid funding lawsuit
Local perspective:
In January, Medicaid Administrator Dr. Mehmet Oz announced the Centers for Medicare and Medicaid Services would withhold $2 billion in Medicaid funding for Minnesota.
The decision followed an audit by the centers of Minnesota’s Medicaid programs. The funding suspension also followed a new batch of federal Medicaid fraud charges that came down in December. During a news conference, as prosecutors announced new charges and guilty pleas related to fraud, federal prosecutors estimated that fraud in Minnesota’s Medicaid programs could total as high as $9 billion since 2018.
The other side:
Since that press conference, the $9 billion figure has been heavily disputed by state leaders who say there is currently no evidence that fraud in Minnesota is that rampant. Gov. Walz and other state leaders say that while fraud is an issue, President Trump has weaponized it to commit political retribution against the state.
What’s next:
FOX 9 has reached out to state officials to see how many providers are facing disenrollment as the deadline hits on Sunday.
Earlier this year, Attorney General Keith Ellison filed a lawsuit over the pulled Medicaid funds. This month, a judge granted a mutual motion for a stay in the case – a 120 pause – to give the federal government and Minnesota time to resolve the funding issue. An update is due to the court by early September.
A 29-year-old man drowned at a lake in northern Minnesota on Saturday, according to the sheriff’s office.
The Crow Wing County Sheriff’s Office said the man drowned at the swimming area at Little Emily Lake Park. The man was at the park with family and friends at the time.
First responders arrived at the scene to try and rescue him, but he was pronounced dead, according to the sheriff’s office.
“Our thoughts and prayers are with the victim’s family and friends during this incredibly difficult time,” the sheriff’s office said.
Little Emily Lake is about 40 miles north of Brainerd.
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