Minnesota is taking steps to bolster the integrity of its Medicaid payments by introducing an additional verification process aimed at curbing fraud in high-risk programs. However, despite this initiative, a former law enforcement expert casts doubt on its effectiveness, as federal authorities claim that more than $9 billion in taxpayer money has been lost to fraud in the state since 2018.
The Minnesota Department of Human Services (DHS) has announced that an extra layer of scrutiny will be applied to payments from Medicaid programs deemed vulnerable to fraudulent activities. This new measure involves collaboration with the healthcare firm Optum, which will conduct a thorough review of payments before they reach individual providers.
Should any discrepancies or potential fraud be detected during this review, the payment requests will be forwarded to the Office of Inspector General for a detailed investigation.
Despite these efforts, Jonathan Gilliam, a former FBI special agent, expressed skepticism about the impact of this additional verification step. In a statement to Fox News Digital, Gilliam argued that the new measure is unlikely to make a significant dent in the overall fraud issue.
“Adding an extra layer of verification won’t be effective,” Gilliam commented. “While it might catch some instances of fraud, it won’t substantially alter the broader situation.”
“Putting an extra layer in is not going to help,” Gilliam said. “And one layer is not gonna stop any, it may stop one part of the fraud, it’s not really gonna make any difference overall.”
Gilliam said Democratic Minnesota Gov. Tim Walz committed “at the minimum malpractice” by the sheer amount of fraud that was committed in his state.
The move comes after federal prosecutors announced in mid-December that 14 programs in the state contained fraud, adding those programs cost Minnesota taxpayers $18 billion since 2018.
First Assistant U.S. Attorney Joe Thompson said during a news conference that half or more of the $18 billion is suspected to be fraudulent.
The sun shines on the Minnesota State Capitol on Monday, Feb. 12, 2024, in St. Paul, on the opening day of the 2024 session of the Minnesota Legislature. (Steve Karnowski/Associated Press)
“When I say significant, I’m talking in the order of half or more. But we’ll see,” Thompson said. “I think a significant portion.”
Thompson revealed during the news conference that six more people were recently charged in connection to an alleged Minnesota housing services fraud.
In one case alone, the defendant is accused of submitting $1.4 million in fraudulent claims, then using some of the money to buy cryptocurrency. That person fled the country after being subpoenaed, Thompson added.
In one of the larger fraud cases gripping the Land of 10,000 Lakes, the Feeding Our Future scheme cost taxpayers nearly $250 million, after the program’s director approved nonexistent meal services going to poor people.
The current iteration of the Minnesota state flag as seen in St. Paul, March 24, 2022. (Mohamed Ibrahim/Report for America via AP, File)
Criminal defense attorney Sam Bassett told Fox News Digital that someone likely should have detected the fraudulent activity well before it escalated to this point.
“I think it remains to be seen when the details come out, but it does have that tenor about it right now that somebody should have done something sooner. Maybe this should have been detected much sooner to prevent continued violations,” Bassett said.
Fox News Digital reached out to Walz’s office and DHS for comment.
