The Minnesota Department of Human Services (DHS) has disenrolled 60% of providers from 13 high-risk Medicaid programs as part of a federal requirement to revalidate nearly 5,600 providers by May 31.
Over 3,400 providers were removed, mainly due to incomplete paperwork, according to the Minnesota Department of Health. However, some disenrolled providers said that they submitted all required documents and still had their services terminated. They also expressed concerns that many DHS employees are newly hired and lack the necessary experience.
Disenrolled providers will immediately stop receiving payments and have two months to appeal the decisions. To assist affected recipients, DHS has launched a new website to help them find alternative providers. Yet, only 59 providers were flagged for further investigation by the Office of Inspector General, with no further details currently available.
Deputy Commissioner Shireen Gandhi highlighted the importance of accurate documentation, stating, “This is not just checking the box.” Many providers worry they were disenrolled because DHS ran out of time to process their applications before the deadline.
As of May 27, a significant number of provider statuses were still pending.
DHS could not provide specific figures on how many Medicaid recipients would be affected but mentioned that over 800 appeals are currently in progress.
Sue Schettle, CEO of the Association of Residential Resources in Minnesota, pointed out that many members submitted their required documents but did not receive any feedback. She emphasized that these long-standing providers are facing unprecedented scrutiny.
Earlier this year, the Trump administration froze $243 million in Medicaid funding, citing Minnesota’s failure to adequately address fraud. In response, the state implemented a corrective action plan that included this revalidation process.
Kristin Robbins, Chair of the House Fraud Prevention and State Agency Oversight Committee, expressed concern over the number of disenrollments, describing them as “astonishing and problematic.” DHS noted that common reasons for disenrollment include failing to disclose management changes, submitting incomplete applications, and lapses in reporting credentials. Providers were required to submit documentation regarding ownership, locations, licenses, and personnel involved in Medicaid services.
