State Medicaid Revalidation Process Leaves some Providers in Limbo
A federal funding dispute forced Minnesota to review about 5,500 providers in five months, and only about 1,000 had passed by last Wednesday.
- On Monday, June 1, the Minnesota Department of Human Services terminated Medicaid billing access for providers whose revalidation paperwork remained in "pending" status after the Sunday, May 31, deadline.
- Federal officials withheld up to $2 billion in Medicaid funding over fraud concerns, forcing DHS to audit about 5,500 high-risk providers within five months—a process typically taking two years.
- Association of Residential Resources in Minnesota CEO Sue Schettle stated providers face "confusion, inconsistent communication" and service cuts because the state failed to complete its verification process.
- MAC Midwest compliance officer Jen Diedrich reported some centers "failed their site visits" due to administrative errors, while operators like Codi Warnecke funded payroll from personal savings during appeals.
- More than 3,300 providers remain listed as pending, and the department has not shared updated data on how quickly appeals will be resolved or when funding might be restored.
19 Articles
19 Articles
State Medicaid revalidation process leaves some providers in limbo
ROCHESTER — Jen Diedrich remembered the moment this spring when the paperwork for each of MAC Midwest's 18 autism care centers, all in one go, were marked as "approved" in an online portal. This meant the Minnesota Department of Human Services would start doing its on-site visits as part of its fraud-fighting Medicaid provider revalidation process — the deadline for which was Sunday, May 31. "For the last three weeks, really, we've been waiting …
Questions over DHS revalidation process still remain
Minnesota’s Department of Human Services (DHS) made an agreement with the federal government to revalidate more than 5,500 high-risk Medicaid providers. The agency’s most current online data shows just over 1,000 providers have been approved and just over 1,000 have been disenrolled from federal funding.
Advocates say thousands of legitimate providers disenrolled from high-risk Medicaid programs
Providers and disability advocates worry many providers were disenrolled simply because the Department of Human Services ran out of time to revalidate providers.
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