Human Services completes review of 5,500+ Minnesota Medicaid providers, disenrolling thousands

Minnesota officials say they have completed a review of almost 5,6000 "high-risk Medicaid providers," part of an effort to stave off the federal government's freezing of $2 billion in funding.

The Minnesota Department of Human Services said the review took five months and was finished on Sunday.

DHS said it reviewed 5,583 providers, of which 2,061 were revalidated and are providing services without interruption. The department notified 3,411 providers they will be disenrolled, 111 were removed from review because they no longer provide high-risk services and 59 were sent to the Office of Inspector General for further review.

Of the 3,411 set for disenrollment, 2,491 provided incomplete paperwork and documentation, 916 failed verification at site visits and four failed a background study, DHS said.

Providers may appeal their disenrollment, DHS said, but in the meantime, some Minnesotans may see disruptions to their services. WCCO spoke to some of those affected, including Richelle Smith, who has lost housing for her and her 10-month-old daughter because the owner faces federal charges.

"With all the fraud going on, there's not a lot of options anymore," Smith said.   

Some providers also say the revalidation process was rushed and prone to error. 

The Trump administration said in January it would pull $2 billion in annual Medicaid funding from Minnesota if the state didn't make changes to combat fraud. DHS said the completed review is a "key part" of keeping that funding flowing, along with efforts such as "enhanced pre-payment review for high-risk providers, a temporary freeze on new provider enrollment in high-risk programs, and auditing and implementing provisional licensure for autism service providers."

Provider says confidence in state system at "all-time low"

Thursday's announcement came just as a meeting with confused Medicaid providers began.

"If you ask me about my overall confidence in our state system right now, it's probably at an all-time low," Josh Berg of Accessible Space said. 

Berg is among those who feel that an inconsistent process has needlessly punished them. He runs Accessible Space Inc., which offers Integrated Community Supports (ICS). It means caretakers provide in-unit assistance for people with spinal cord injuries and disabilities. He said that while two of their locations have the green light to continue, DHS terminated funding to five of them.   

"If you ask me about my overall confidence in our state system right now it's probably at an all time low," Berg said.   

Berg and Accessible Space are helping people like Mike Hill. 

"We have lives," Hill said.

Hill said his life is now more stressful after finding out his home is one of the locations for which DHS terminated funding. It's one of five Accessible Space sites that are cut off. Berg says two others got the green light to continue. He's left frustrated by what he calls an inconsistent and confusing process.

It's a process that began about four months ago, an effort so widespread that state employees at other agencies were quickly trained and deployed to help DHS revalidate providers. 

Berg and more than three hundred others joined an otherwise routine meeting with DHS on Thursday morning to ask questions, with some saying they're the victim of DHS errors. Some said that they didn't get in-site visits at the right locations; others said they weren't sure how to appeal because they didn't understand why they were penalized in the first place.   

"It was frustrating that we're still talking about a lot of the same issues that have been raised for months or weeks," Berg said. "We'll make it, but many organizations will not. which means many people receiving services will lose access." 

There's an appeal process underway.

At Accessible Space, Berg says they can be self-sufficient for a while. It's not the same everywhere, and he's concerned about other providers going under without money from Medicaid.