[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6520434,"mediaKeyId","5331645-c64efa36bb1d358240926ebd3657a98a","parentId",5331645,"title","Committee approves May 5 minutes by voice vote","audioSeconds",30,"startMs",2545000,"endMs",2575000,"viewUrl","/Search/View?dp=1&key=5331645-c64efa36bb1d358240926ebd3657a98a&start=2545&end=2575","thumbnailUrl","https://assets.pipeline.soar.com/5331645-c64efa36bb1d358240926ebd3657a98a/thumbnail_2545000.jpg","articleUrl","/articles/6520434/Minnesota/Committee-approves-May-5-minutes-by-voice-vote","mediaUrl","https://secure.pipeline.soar.com/6520434-4efbc15f25a19e62039e54fc3c010636/orig.mp4?Expires=1770922049&Signature=k3lb46tPCGKDL0QsZ0rE5ynYcBu-C54oxeoaC0qyI7kOa--jOw1NUl-BhkLPUMVEKIAdltGf-L7VyIDrUwfL1QAZhgPE0Rw0v-pI0OG9qZZxlYu1Bho9muIFPW7xBLFWknKDzzJwQyJmjWn3AOV4adZ2Xqd4Yi2IgB4x1xTk4sXjbxxaFGa057~cneoR3-FfPbzdMieu-T0v0Fnv-V-Fgtfr-kmjDxELGf53eWLpxH3LgTz5ahExNSrVrvyYxbWT87lWSXatyHELWGjyVWUtkgh7U~4AxLSqjYjXkjGLoG00FXB9VUdUIjlrWEgD9cqufODaD1Ak55eXCMCHQNMYLA__&Key-Pair-Id=KUT5TJCACFTXG","author","Minnesota Legislature","date","2025-07-08T19:05:44.387Z","article","At the June 24 interim hearing, Vice Chair Anderson moved to approve the committee minutes from the May 5 meeting. Committee members signified approval by voice vote; the chair announced the minutes were accepted.

The motion was moved by Vice Chair Anderson and carried by voice vote; no roll-call tally was recorded in the transcript.

Ending: The committee then proceeded to member questions for DHS leadership and the Office of Inspector General.

","mediaType","Video","parentTitle","House Fraud Prevention and State Agency Oversight Policy Committee 7/8/25","oneSentenceSummary","The interim committee approved minutes from its May 5 meeting by voice vote after a motion from Vice Chair Anderson.","taxTitle","2025 Legislature MN, Minnesota","taxId",77817,"location","Minnesota","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6520439,"DHS outlines eligibility checks, counties' role and warns federal changes may reduce coverage",728,1727000,2455000,"/Search/View?dp=1&key=5331645-c64efa36bb1d358240926ebd3657a98a&start=1727&end=2455","https://assets.pipeline.soar.com/5331645-c64efa36bb1d358240926ebd3657a98a/thumbnail_1727000.jpg","/articles/6520439/Minnesota/DHS-outlines-eligibility-checks-counties-role-and-warns-federal-changes-may-reduce-coverage","https://secure.pipeline.soar.com/6520439-fab3cbad295a70cc82aa9b498a5ec162/orig.mp4?Expires=1770922049&Signature=IErxtMINiM3ilO1iJPhemoIwKOk8C6GyPNwJa1chFUTsDwXnzubFcaAzbXO-DQfXZx2zbEj3q7dNImf2thd0euvITTBTsNR~6SjthkZH2JTq9oKYj9WqVYeu6cfpudbAVB1XtPnPuP4g0JABEammrYZfaUFUhXcXhxuP7eFEAxzornLT5wyGdEhkGQR3D3o4ttqU5xxwYntZWiSN5FeIoIa9z8wW~rBcDzI~FvH5VaBboaqH2LRxHkr96OSwSuNwKPKQ8ZugD-3e0pIYIBZ6EKchnmfkDcAj1G8Xs2NqPG8451jU7mdZ0o9MUaxkAOdmw4BL7Z9GXnLVPvqPNX8s-A__&Key-Pair-Id=KUT5TJCACFTXG","Shereen Gandhi and John Connolly of the Minnesota Department of Human Services told a June 24 interim hearing that counties make individual Medicaid eligibility determinations and that eligibility checks rely heavily on electronic data sources.

Gandhi said federal law sets minimum Medicaid eligibility rules and Minnesota county workers use a set of \"trusted data sources\" to confirm information at renewal and between renewals. She listed several data sources DHS uses to corroborate applications and renewals: Social Security Administration records (to verify Social Security numbers, benefits, citizenship and deaths); the Department of Homeland Security (immigration status); the Internal Revenue Service and Equifax/The Work Number (wage verification); the Minnesota Department of Employment and Economic Development (wages and unemployment); an asset verification service (financial accounts for those subject to asset limits); and Minnesota death records.

Gandhi described renewal procedures: agencies must first attempt to auto-renew with trusted data sources; if that does not confirm eligibility, a renewal form is mailed and nonresponse results in case closure after a 10-day advance closing notice. She said renewals resumed after the pandemic'era continuous coverage ended March 31, 2023, and DHS completed the backlog of renewals by June 2024.

On federal changes, Gandhi said the federal Budget Reconciliation bill signed July 4 imposes new requirements that DHS is still assessing but that DHS estimated could \"cut roughly $500,000,000 in annual funding to Minnesota\" and that the Kaiser Family Foundation has projected \"between 400,000 Medicaid enrollees in Minnesota will lose coverage because of the bill.\" She said the bill adds six-month eligibility checks, work-reporting requirements for some adults and other changes that increase administrative burdens for counties, hospitals and navigators.

Matt Freeman of the Association of Minnesota Counties told the committee counties will bear much of the administrative workload. Freeman said Minnesota is one of 10 states where counties administer Medicaid eligibility and that prior analyses estimate substantial local fiscal impacts from imposing work requirements. He warned that increased verification steps and older state eligibility systems (SSIS, MAXIS) create operational challenges and increase the likelihood of administrative errors that can close cases for otherwise eligible people.

John Connolly, DHS deputy commissioner and state Medicaid director, said nationally and in Minnesota roughly two-thirds of working-age Medicaid enrollees already work and that a small share would be newly motivated into work by a work requirement. He also said evidence shows administrative hurdles and frequent redeterminations can cause eligible people to drop coverage.

Gandhi and county representatives asked for time to analyze the federal law's specific operational costs and system-change needs; DHS said some federal approvals and contract or system work could take three to six months.

Ending: Committee members asked DHS and counties for follow-up information: (1) counts on how many people the federal changes may affect, (2) specific estimates of additional county workload and cost, (3) managed care audits and reports on MCO-reported fraud detection, and (4) DHS figures for administrative recoveries and unrecovered overpayments.

","DHS told lawmakers counties determine individual Medicaid eligibility and that recent federal legislation will require more frequent checks and could reduce enrollment; DHS and county representatives said implementation will add administrative work and may require system upgrades and funding.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6520444,"DHS details Office of Inspector General work, new provider checks and licensing changes",1023,674000,1697000,"/Search/View?dp=1&key=5331645-c64efa36bb1d358240926ebd3657a98a&start=674&end=1697","https://assets.pipeline.soar.com/5331645-c64efa36bb1d358240926ebd3657a98a/thumbnail_674000.jpg","/articles/6520444/Minnesota/DHS-details-Office-of-Inspector-General-work-new-provider-checks-and-licensing-changes","https://secure.pipeline.soar.com/6520444-49f7c7751f664349a6f0d49cae135594/orig.mp4?Expires=1770922049&Signature=TLtMUZkkT6kb~y5ctmUeFisL2ohs6Sj6bKrtFKA~ILxnISvUarzAZC6Y1CLzjNJPGVPMOk15b~9nUYCSMj69J9oYaMuj2Z38sZDyKEftk0euFMVPXkdTuhab2j6QUL4ImO9OeQi-HeeX6nbEoHRNMtlOmpwK6GI4Tk1Xi5HYY45pb0bzSjv7L2BSZhJ-fcyQ18QX5U8U-94x6Ae5vOoXSe5jblvykZBwGHOlINMhPVi04krvZlA4V28i6xIwGq-wKs71t7Kn8SyD2~9xi2TySLBVmNSydlVa4HLcRcKMyMcr3~Z77UYKswLFfcEJhFfxZu6blqVkl4ZXZHdkvInbZQ__&Key-Pair-Id=KUT5TJCACFTXG","Shereen Gandhi, the temporary commissioner of the Minnesota Department of Human Services, and James Clark, the agency's newly appointed inspector general, told a June 24 interim legislative hearing that DHS has expanded front-end vetting, licensing and investigative steps to reduce fraud and protect Medicaid enrollees.

Gandhi said Minnesota Medicaid serves more than 1,000,000 people and that the administration and legislature worked this past session to add program-integrity tools. She described enacted changes that give DHS new authorities to share claims data with state and federal agencies, withhold payments, suspend licensure while investigations proceed and require pre-enrollment provider training.

The department also singled out reforms targeted to specific services. Gandhi said the session created a provisional license for early intensive developmental and behavioral intervention (EIDBI) providers, shortened revalidation cycles for those providers from five years to three, tightened background-study requirements and expanded DHS's ability to investigate maltreatment allegations connected with EIDBI. For the housing stabilization services program, she said the law imposes a 100-hour annual cap per client, limits remote supports to no more than 20% of services and requires pre-enrollment training and increased site visits, including unannounced inspections.

Inspector General James Clark described three core OIG functions: conducting background studies, licensing oversight and provider investigations. Clark said the Background Studies Division carries out roughly a half-million background checks annually to prevent individuals with disqualifying criminal conduct from accessing vulnerable recipients or Medicaid dollars. He said the Licensing Division conducts site visits, reviews records and interviews recipients to ensure programs follow statutes and rules, and that the OIG currently oversees about 300,000 Medicaid providers.

Clark told the committee his office opens investigations when complaints or data analytics identify providers who are actively billing and where the allegations merit a full review. Investigations can include document reviews, on-site visits, interviews and financial record reviews; outcomes range from administrative actions and repayment demands to referrals to prosecutors or federal law enforcement. \"The fact that people decide to steal from taxpayer funded programs that are designed to help people in need is reprehensible. Personally, I find it disgusting,\" Clark said.

Both Clark and Gandhi emphasized the role of data analytics and outside partners. Clark described an in-house analytics team that monitors billing data and said DHS contracts with federal and private contractors, including CMS-mandated contractors (UPIC) and private auditors, to flag billing outliers and conduct provider audits. Gandhi highlighted Minnesota's reliance on managed care organizations, noting the state is about 90% managed care and that MCOs run special investigative units that also detect potential fraud.

Gandhi and Clark described a multi-step complaint intake process: intake staff screen tips, request clarification when needed, run preliminary checks to see if a provider is actively billing, and escalate to a full investigation when appropriate. Clark said OIG currently has nearly 1,000 open provider investigations but that not all investigations allege criminal fraud; many reflect administrative errors or documentation issues.

Gandhi acknowledged the office recently implemented a pre-enrollment risk-assessment process (PERA) effective July 1 and now requires additional documentation from providers, including proof of surety bonds in some cases. She said DHS has added staff to handle increased eligibility and compliance checks, increasing capacity for on-site screenings and background studies.

The witnesses said the OIG collaborates closely with DHS policy teams to translate investigative findings into statutory and administrative changes intended to strengthen compliance and enforcement.

Gandhi and Clark were asked repeatedly about staffing and recovery rates. Clark said roughly 30 investigators handle provider investigations; Gandhi said DHS handles many administrative recoveries and can suspend payments during investigations. Both officials said they would provide committee members with more detailed staffing and recovery figures after the hearing.

Ending: Clark and Gandhi said DHS plans to continue expanding risk-based vetting, data analytics and interagency referrals to hold bad actors accountable while preserving access to benefits for eligible Minnesotans.

","Minnesota Department of Human Services leaders described recent program-integrity reforms, the Office of Inspector General's investigative role and front-end screening steps the agency says it has added to detect and deter Medicaid provider fraud.","actionData","errors"]

Article not found

Committee approves May 5 minutes by voice vote

DHS outlines eligibility checks, counties' role and warns federal changes may reduce coverage

DHS details Office of Inspector General work, new provider checks and licensing changes