As Minnesota faces scrutiny over fraud in its public assistance programs, the state is planning to freeze provider enrollment across 13 Medicaid services, according to a Jan. 8 news release from the Minnesota Department of Human Services.
The statement said CMS pushed for Minnesota to stop new providers from enrolling in the “high-risk categories,” as well as revalidate current enrollment. The pause is anticipated to last six months, but the department has not set a start date.
These are the 13 affected service categories:
- Adult companion services
- Adult day services
- Adult rehabilitative mental health services
- Assertive community treatment
- Community-first services and supports
- Early intensive developmental and behavioral intervention
- Individualized home supports
- Integrated community supports
- Intensive residential treatment services
- Night supervision services
- Nonemergency medical transportation services
- Peer recovery support services
- Recuperative care
The move does not freeze client enrollment and will be open to exceptions, which must be approved by CMS.
“To ensure Minnesotans can receive critical services everywhere they live, the department will issue exceptions to add new providers where capacity is needed,” the news release said.
The state already administered a licensing freeze on home- and community-based services and adult day programs through an executive order from Gov. Tim Walz.
Minnesota is among five states suing HHS over a $10-billion funding freeze for child care programs targeting low-income families. The lawsuit follows HHS pulling back all federal child care payments from the state, stemming from fraud concerns at day care centers. Optum is now reviewing more than 80,000 claims covering the high-risk Medicaid services — as well as the discontinued housing stabilization services program — as part of an enhanced prepayment audit. Payments to these services are frozen as the audit proceeds.
