Minnesota's new Medicaid fraud prevention fix won't make 'any difference,' former FBI agent says
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Minnesota is ramping up efforts to secure its Medicaid payments by introducing an extra verification step aimed at reducing fraud in high-risk programs. Despite this move, a former law enforcement expert remains skeptical, pointing to a staggering $9 billion in taxpayer losses since 2018, as highlighted by federal investigators.

The state’s Department of Human Services (DHS) has implemented a new measure where health care company Optum will conduct a review of Medicaid payments before they are issued to providers. This step is intended to enhance the auditing process and prevent fraudulent claims.

Should any suspicious activity be detected in a payment request, it will be escalated to the Office of Inspector General for a comprehensive investigation.

However, Jonathan Gilliam, a former FBI special agent, expressed doubts to Fox News Digital regarding the effectiveness of this new verification step, suggesting it may not significantly impact the prevention of fraud.

Tim Walz speaks

Governor Tim Walz of Minnesota addressed the issue, emphasizing the importance of maintaining integrity in the state’s Medicaid programs. (Image credit: Justin Sullivan/Getty Images)

“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.

MN state capitol in sunlight

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.

Minnesota state flag.

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.

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