Minnesota Moves to Limit Medicaid Fraud With Provider Freeze

St. Paul, MN (KROC-AM News) - The State of Minnesota today announced new actions aimed at limiting the state’s exposure to fraud.

The announcement involves a freeze on new provider enrollments covering 13 categories of Medicaid services considered at high risk for fraud.

A statement issued by the Minnesota Department of Human Services says the agency is working with federal authorities to implement the freeze, which is initially expected to last six months. Once it is in place, the state will no longer accept new applications from businesses wishing to provide services through the affected programs.

“This action is one more step we are taking to disrupt fraudulent billing,” Temporary Human Services Commissioner Shireen Gandhi said. “We must safeguard Medicaid resources, always mindful that access to these programs is a lifeline for so many Minnesotans.”

The 13 categories impacted by the freeze are:

• Adult companion services 
• Adult day services 
• Adult rehabilitative mental health services 
• Assertive community treatment 
• Community First Services and Supports 
• Early intensive developmental and behavioral intervention 
• Individualized home supports 
• Integrated community supports 
• Intensive residential treatment services 
• Night supervision services 
• Nonemergency medical transportation services 
• Peer recovery support services 
• Recuperative care

A news release from the state agency says the U.S. Centers for Medicare and Medicaid Services has also directed the state to review and revalidate enrollment for current providers of services in the 13 high-risk categories. Details concerning the requirements and timeline for that process have not yet been finalized.

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State officials say the freeze will not impact the ability of currently enrolled providers to continue serving clients in areas they are already approved to provide. It also does not include a moratorium on enrolling new clients. Exceptions will be issued in cases where additional capacity is needed to meet service demand.

The Minnesota Department of Human Services previously announced a two-year licensing freeze for home- and community-based services and adult day programs due to concerns about fraud. The state has also disenrolled more than 800 inactive providers in high-risk programs and terminated housing stabilization services because of widespread fraud.