July 23--The Minnesota Department of Human Services is commissioning an independent audit to respond to lingering questions about how the state's Medicaid program paid rates to private HMOs between 2003 and 2011.
The rate-setting process in Medicaid is also the subject of several federal investigations.
Questions have swirled at the Capitol this year about whether Minnesota officials had been manipulating the rate certification process in Medicaid to wrongly gain excess federal money.
"The analysis will conduct a thorough review of Minnesota'sMedicaid payments to third-party managed care companies for the fiscal years of 2003 through 2011," wrote Lucinda Jesson, the state's human services commissioner, in a letter to legislative leaders dated Monday, June 23.
"This independent analysis will allow an outside independent expert to address, once and for all, whether the state's payments to those contractors were higher than the amounts allowable under state and federal law," Jesson wrote. "The results of this analysis will also inform the Medicaid contracting reforms undertaken by our administration since 2011."
Medicaid is a health insurance program for low-income people and those with disabilities; it is jointly funded by states and the federal government. The majority of Medicaid beneficiaries in Minnesota have their care administered through managed-care organizations including nonprofit HMOs.
Christopher Snowbeck can be reached at 651-228-5479. Follow him
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