Minnesota officials announced an “unprecedented” effort to revalidate more than 5,800 Medicaid service providers within 13 high-risk categories in response to widespread fraud, waste, and abuse. According to John Connolly, Minnesota Department of Human Services deputy commissioner and state Medicaid director, the initiative will involve recruiting 168 current state employees to conduct site visits over the next four months, beginning this month with the goal of reviewing all providers by the end of May. The targeted categories include behavioral intervention providers for youth with autism and adult day services.
This revalidation effort, dubbed “Minnesota Revalidate,” follows several state actions taken since September 2025 to combat fraud. The state has frozen new provider enrollment in the 13 high-risk categories, disenrolled inactive providers, ended its housing stabilization services program, and started a prepayment audit process for Medicaid claims. Connolly stated that individuals involved in Medicaid fraud “didn’t just take money from our neighbors in need; they robbed us of some of our confidence that we can care for each other.” The Minnesota Department of Human Services has both appealed a threat from the U.S. Centers for Medicaid and Medicare Services to withhold $2 billion per year and submitted a revised corrective action plan that addresses all items listed in a January 6 CMS letter.
Investigation Uncertainty and Expansion Plans
The revalidation effort comes amid uncertainty about future criminal prosecutions. Several prosecutors in the U.S. Attorney’s Office for the District of Minnesota, which had been charging individuals in connection with alleged Medicaid fraud, resigned on January 13. Inspector General James Clark said he has not received communications from the office since those resignations. Future plans include expanding the prepayment audit process to also review claims made through managed care organizations, which currently serve most recipients of Minnesota Medicaid and other state-run health programs.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.dl-online.com/health/minnesota-will-revalidate-nearly-6-000-medicaid-service-providers-by-summer-officials-say