Minnesota Department of Human Services Cuts off Medicaid Funds to 3,411 Providers Working in High Risk Areas for Fraud
St. Paul, MN (MinnesotaNow)- The Minnesota Department of Human Services (DHS) says it has completed a review of thousands of Medicaid providers deemed to be working in areas at high risk for fraud.
Read More: Minnesota Moves to Limit Medicaid Fraud With Provider Freeze
Over the course of five months, the state agency examined 5,583 providers working in 13 high-risk areas. DHS and the federal government issued a freeze on new provider enrollments in January.
A news release issued by DHS on Thursday says the completion of the review is a “key part of Minnesota’s plan to stop the federal government from withholding up to $2 billion from its Medicaid program.”
Minnesota DHS Disenrolls Over 3400 Providers Working in Areas at High Risk for Fraud
3,411 of the nearly 5600 reviewed providers were notified of disenrollment, the news release says.
DHS says 2,491 of the disenrolled providers were cut off due to “were due to submissions of incomplete paperwork and documentation.” 916 were due to failed verification during site visits and four failed background study.
The state agency also said that 111 providers were removed because they’re no longer providing high risk service and 59 providers were referred to the newly-formed Office of Inspector General Office for further review.
Areas Deemed High Risk
The categories deemed at high risk for fraud were:
- 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
The DHS news release says the main reasons for the disenrollments were due to “failure to disclose management authority or report change in ownership, failure to report changes in or maintain proper credentials such as liability and surety bonds, failure to provide access and incomplete applications.”
Providers who have been kicked off the Medicaid recipient list have 60 days to appeal their disenrollment. DHS says.
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Gallery Credit: Troy Dunken
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