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

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…