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Committee debates requiring MCOs to verify Medicaid enrollees live in Minnesota; plans and counties warn of harms
Summary
House File 2604 would require Medicaid managed-care organizations to contact enrollees to verify Minnesota residency and to document an attestation; the measure drew sharp questions from health-plan and county witnesses about administrative burden and risks to eligible enrollees.
Representative Backer introduced House File 2604, which would require Medicaid managed-care plans to verify that an enrollee is a living Minnesota resident by having the enrollee attest to a Minnesota address; failure to verify could lead to payment being stopped, according to the bill’s description.
Key points: The sponsor said the proposal is intended to protect taxpayer dollars by adding a second check (a “second set of eyes”) to flag improper payments for ineligible enrollees, citing national statistics about improper Medicaid payments and prior state audit findings. The bill does not require redetermination of eligibility, the sponsor said; it instead asks MCOs to reach out to enrollees and document an attestation.
Opposition and concerns: Witnesses from the Minnesota Council of Health Plans and others told the committee they share the goal of program integrity but raised three main concerns: (1) the proposed verification would add a step for enrollees who already face barriers (paper processes, language, county backlogs) and risk delaying access to care; (2) eligibility verification is a county/DHS responsibility done prior to enrollment, and shifting tasks to MCOs would duplicate work and raise costs; and (3) financial impacts on plan solvency could result from added payment-withhold and administrative burdens. Members and witnesses described the difficulties counties and DHS experienced during recent redeterminations and urged modernization of county/DHS systems rather than adding manual paper attestations.
Questions from members focused on whether the bill would require paper attestations and on how the administrative costs would be paid. The author said the bill provides another check on taxpayer dollars and that the committee would work on implementation details; witnesses said no cost estimate for the new administrative burden was provided at the hearing.
Outcome: House File 2604 was laid over for possible omnibus inclusion; members asked for further analysis of costs and implementation pathways.
