Attorney General Ellison discusses Medicaid fraud at Minnesota oversight committee meeting

On May 5, 2025, the Minnesota Legislature convened the House Fraud Prevention and State Agency Oversight Policy Committee to address critical issues surrounding Medicaid fraud. The meeting highlighted the ongoing efforts of the Attorney General's office and the Medicaid Fraud Control Unit, emphasizing their role in protecting vulnerable populations and ensuring taxpayer dollars are used appropriately.

The session began with a recognition of the committee's staff, who played a vital role in facilitating discussions on fraud prevention. Chair Robbins expressed gratitude for their hard work, setting a collaborative tone for the meeting. Following the approval of previous minutes, the committee turned its focus to an informational hearing on Medicaid fraud, featuring testimony from Attorney General Keith Ellison and his team.

Ellison outlined the scope of the Medicaid Fraud Control Unit, which has been operational for over 40 years. He emphasized that the unit is dedicated to investigating and prosecuting cases of provider fraud and the abuse of vulnerable adults. Notably, the unit operates under a federal grant that covers 75% of its funding, allowing it to recover significant amounts of money for the state. Over the past five years, the unit has recovered $53 million while spending only $5 million, showcasing a strong return on investment.

Nick Wonka, the director of the Medicaid Fraud Control Unit, provided detailed examples of recent cases, illustrating the serious nature of Medicaid fraud. He described instances where providers billed for services not rendered, highlighting the impact on vulnerable individuals who rely on these essential services. The cases presented included a home care agency that defrauded the system of $1.8 million and a mental health therapist who exploited patients for over a million dollars.

The committee also discussed the limitations faced by the Medicaid Fraud Control Unit, particularly regarding staffing levels. Despite an increasing state Medicaid budget, the unit's size has remained static at 32 staff members, which is below the recommended level based on Minnesota's Medicaid budget. This discrepancy raises concerns about the unit's capacity to effectively combat fraud as the program expands.

In conclusion, the meeting underscored the importance of legislative support for the Medicaid Fraud Control Unit, particularly through the proposed Medical Assistance Protection Act. This legislation aims to enhance the unit's capabilities and align its staffing with federal recommendations. As discussions continue, the committee's commitment to safeguarding taxpayer funds and protecting vulnerable Minnesotans remains a priority. The next steps will involve further deliberations on the proposed legislation and ongoing efforts to address the challenges faced by the Medicaid fraud prevention efforts in Minnesota.