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Governor Tim Walz has ordered a third-party review of Medicaid billing through the state's Department of Human Services as two major fraud investigations are underway. Medicaid billing audit in MN What we know: The governor's office announced it would move forward with a third-party audit of Medicaid billing through the Department of Human Services. The audit will be performed by Optum, which will review claims and flag potential issues for DHS to follow up on. Optum will look for improper claims, missing documentation, high billing patterns, and other inconsistencies, a release from the governor's office states. What's next: The state says claims flagged by Optum will be checked by DHS and suspected improper claims will be referred to the Office of Inspector General for an investigation. Fraud cases in Minnesota The backstory: The audit comes as the U.S. Attorney's Office has announced charges in a massive Minnesota Housing Stabilization program fraud scheme and a scheme targeting a state program to help those on the autism spectrum. Both fraud cases come on the heels of the massive investigation and criminal case into Feeding Our Future, an organization that bilked more than $250 million from a USDA and Minnesota Department of Education program to feed school children during the COVID-19 pandemic. The investigation into Feeding Our Future led federal prosecutors to uncover some of the other fraud. The state has already identified 14 Medicaid services it deems at high-risk based on "programmatic vulnerabilities."
