Minnesota DHS freezes new provider enrollment for 13 Medicaid services over fraud concerns
The Minnesota Department of Human Services announced on Thursday that it is freezing new provider enrollments in 13 categories of Medicaid services, which it says are at high risk for fraud.
The department does not have a start date for the freeze, but it is slated to last at least six months.
Among the 13 categories deemed high risk for fraud are adult companion, day and rehabilitative mental health services, individualized home supports, residential treatment services and more.
"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 department says that currently enrolled providers can continue to serve clients and that the action does not freeze client enrollment. It will also provide exceptions to add new providers where capacity is needed.
The move comes as the agency is under scrutiny for its response to fraud in state Medicaid programs. Federal prosecutors filed criminal charges against providers of both autism treatment services and housing stabilization services, a program that was recently shut down.
Less than a month ago, the Minnesota Department of Human Services implemented a two-year moratorium on new licenses for adult day care centers in response to an uptick in providers that exceeds the number of people who need services.
In the fall, the department also suspended payments to 11 providers that serve adults with disabilities over allegations of fraud.
A newly-released report from the Office of the Legislative Auditor found "widespread failures in oversight" at the Minnesota Department of Human Services' Behavioral Health Administration.
During a House Oversight Committee hearing on fraud in the state on Wednesday, GOP state Rep. Kristin Robbins said the fraud prevention committee in the Minnesota House has identified fraud in multiple Medicaid programs, including autism centers, sober homes, non-emergency medical transportation, integrated community supports and housing stabilization.
