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Committee debates MCO verification bill; health plans warn of access risks
Summary
House File 2,604 would require Minnesota managed-care organizations to verify that an enrollee is a live Minnesota resident by sending an attestation request; supporters urged program integrity while managed-care plans and counties warned the paper-based approach could disrupt care and shift administrative costs.
Representative Backer introduced House File 2,604 to require managed-care organizations (MCOs) to verify that Medical Assistance enrollees are living Minnesotans by having enrollees respond and attest to their residence at a Minnesota address. The bill would not itself redetermine eligibility but would create a second verification channel; failure to respond could result in the state stopping payment for services until the enrollee re-establishes eligibility.
Former Representative Matt Dean (testifying for American Experiment) described large-scale improper-payment estimates and argued for a second set of eyes on eligibility to reduce improper payments. Chelsea Olsen of the Minnesota Council of Health Plans testified in opposition, warning the bill would place an extra burden on already vulnerable Minnesotans, duplicate county and DHS eligibility work, and shift costs and solvency risk to health plans. Olsen recommended modernizing county and DHS systems rather than adding MCO attestations.
Members pressed on paper-based attestations and administrative cost and operational impacts. Representative Elkins and others said requiring paper attestation would be a step backward after the Medicaid redetermination (unwind) process and could increase disenrollments and delays. Representative Backer said she has discussed other verification ideas with plans and that the bill seeks “another set of eyes” to protect taxpayer dollars.
The committee laid the bill over for possible inclusion. Members asked DHS and stakeholders to continue discussions on alternative verification approaches and to identify implementation costs.
Action taken: bill laid over for possible inclusion; committee requested follow-up and further stakeholder work.
