FACT: Speculation is not fraud.

First things first. Fraud is deception intended to result in financial or personal gain with evidence that proves both intention and guilt. Speculation is not fraud. Our investigations continue and the situation is fluid. For this reason, there is no final number at this time.

FACT: Claiming that half of all Medicaid payments for some services are fraudulent is shocking.

Claiming that half of all Medicaid payments for some services are fraudulent is shocking, and unsupported by facts. If there is evidence of Medicaid fraud, the state should be given the information, so MN DHS can immediately stop payments to those individuals and businesses.

FACT: We refer criminals to law enforcement for prosecution.

We move aggressively to suspend payments where we see evidence of fraud, and we refer criminals to law enforcement for prosecution. We more than doubled the number of providers we stopped payments to in 2025 compared to recent years.

FACT: The Minnesota Star Tribune reported on Dec 11, 2025 a total state number of $217.7 million in criminal social services fraud charges across social services programs since September 2022, including $25.65 million in alleged Medicaid fraud.

The Minnesota Star Tribune reported on Dec 11, 2025, a total state number of $217.7 million in social services criminal charges since September 2022, including programs not overseen by MN DHS. A Dec. 18, 2025, news release from the Department of Justice: Six Additional Defendants Charged, One Defendant Pleads Guilty in Ongoing Fraud Schemes detailed these charges: Autism Services (EIDBI / DHS Medicaid): $20.0 million and Housing Stabilization Services (DHS Medicaid): $5.65 million, totaling about $25.65 million in alleged Medicaid fraud.

FACT: Minnesota Attorney General Keith Ellison announced charges against a defendant using a home health agency to commit fraud.

On Jan. 14, 2026, Minnesota Attorney General Keith Ellison announced charges against a defendant using a home health agency to fraudulently bill Medicaid $3 million in services.

FACT: Since 2020, MN DHS has conducted over 3,000 investigations and referred over 500 cases to law enforcement.

Since 2020, MN DHS has conducted over 3,000 investigations and referred over 500 cases to law enforcement. More than $50 million has been identified by MN DHS for recovery.

FACT: Staggering fraud schemes and audits have been uncovered in many states beyond Minnesota.

Staggering fraud schemes and audits have been uncovered in many states beyond Minnesota. For example, a 2025 Justice Department “National Health Care Fraud Takedown” charged 324 defendants in schemes involving over $14.6 billion in alleged Medicare and Medicaid fraud nationwide, including cases tied to New York, Illinois, California, and North Carolina prosecutors. In Arizona, authorities uncovered an approximately $2.5 billion Medicaid fraud scheme targeting behavioral health and sober living claims (2019–2023), and in California, federal prosecutors charged defendants in COVID-era health-care fraud cases totaling over $490 million (2023). In North Carolina, a 2024 federal plea brought charges involving more than $3.5 million in fraudulent federal Paycheck Protection Program loan claims, demonstrating that both pandemic relief and federal health care programs have been exploited in multiple states. Minnesota isn’t the only place where audits and prosecutions are ongoing.

FACT: According to the federal government, Minnesota has a Medicaid improper payment rate well below the national average

According to the federal government, Minnesota has a Medicaid improper payment rate well below the national average when compared to other states. Improper payments are payments that should not have been made or were made in the incorrect amount due to provider billing errors and noncompliance.

Sources: 2022 Medicaid & CHIP Supplemental Improper Payment Data (November 2022) p. 53; 2025 Medicaid & CHIP Supplemental Improper Payment Data (January 2026), p. 52.

FACT: Allowing a program to operate under federal rules is not approval of fraudulent activity.

Fraud is criminal deception. MN DHS did not authorize fraud; criminals external to the state agency falsified records and exploited vulnerabilities. Allowing a program to operate under federal rules is not approval of fraudulent activity. Oversight limitations are not the same as permission.

FACT: Showing up with a camera and the goal of getting YouTube views isn’t the same as conducting a legitimate fraud investigation.

Showing up with a camera and the goal of getting YouTube views isn’t the same as conducting a legitimate fraud investigation—those rely on using qualified investigators and accurate information from appropriate sources. Making it up as you go can result in significant inaccuracies, as we have seen recently, and jeopardize investigatory outcomes.

FACT: Most people don’t come to the building… which is why they weren’t seen in the building.

Those served by the Griggs-Midway building’s businesses are mostly people with disabilities or who are older Minnesotans. Most services are set up by county case workers and are provided in the community or at home. This means most people don’t come to the building… which is why they weren’t seen in the building.

FACT: Investigations are best left to those with training and experience.

The creator incorrectly used the term “licensing lookup number” as if it’s the number of people being served and expected to be present. He may be surprised to learn that licensed capacity references the maximum number of individuals that can be served in the building at any given time, relative to the square footage of the space. It is common for programs to serve fewer people than the licensed capacity allows for. While this may sound “in the weeds,” that’s the point—investigations are best left to those with training and experience.

FACT: Many office buildings across the Midwest are former industrial buildings.

Speculating that “a business housed in an old factory must be fraudulent” shows a lack of understanding of this region and the services being provided. Many office buildings across the Midwest are former industrial buildings.

FACT: We regularly support criminal investigations by law enforcement, and the bulk of prosecutions start with a referral from us.

MN DHS follows up on and reviews every credible allegation, and, when it’s warranted, payments are stopped, and cases are referred for criminal prosecution. We regularly support criminal investigations by law enforcement, and the bulk of prosecutions start with a referral from us.

FACT: Raising speculation is not the same as uncovering evidence.

Raising speculation is not the same as uncovering evidence that the state was billed for services that were not provided. Reporting suspicions to authorities for investigation is always the critical first step.

FACT: Businesses they visited received no Medicaid transportation payments from MN DHS.

A review of records going back seven years shows businesses they visited received no Medicaid transportation payments from MN DHS. Several were not even enrolled as a provider with the state, something that is required in order to bill for services.

FACT: Federal law requires every state’s Medicaid program to cover non-emergency medical transportation.

Federal law requires every state’s Medicaid program to cover non-emergency medical transportation so people with barriers to transportation – such as lack of a driver’s license, inability to use public transportation or need for a wheelchair van or other specialty vehicle – can access necessary medical care.

FACT: The Minnesota Department of Human Services took action in 2025 to designate non-emergency medical transportation as a high-risk service.

In 2025, we designated non-emergency medical transportation as a high-risk service. Owners are now subject to enhanced fingerprint studies, mandated onsite screening visits before billing starts and at minimum every three years, and unannounced site visits from our staff. We also temporarily paused new businesses in the Minneapolis-Saint Paul metropolitan area from joining Medicaid and require a third-party audit of fee-for-service claims before any payments are made.

FACT: Spreading misinformation that Minnesota taxpayers are funding terrorism is designed to manufacture outrage.

Spreading misinformation that Minnesota taxpayers are funding terrorism is designed to manufacture outrage. Federal prosecutors in Minnesota have explicitly said there is no indication or proof defendants charged were funneling money into terrorist organizations.

FACT: Since December 5, we’ve worked with CMS to create a corrective action plan to increase our ability to prevent and detect Medicaid fraud.

Since December 5, we’ve worked with CMS to create a corrective action plan to increase our ability to prevent and detect Medicaid fraud.

After CMS rejected the plan submitted on December 31, we were given until January 30 to either revise our corrective action plan to CMS’s satisfaction, or appeal. We did both.

FACT: We have met all timelines federal officials have set and meet weekly with CMS.

We have met all timelines federal officials have set and meet weekly with CMS.

FACT: We disagree with CMS’s conclusion that our initial plan was inadequate.

We disagree with CMS’s conclusion that our initial plan was inadequate. A cornerstone of the plan is a massive undertaking to visit to 5,800 Medicaid providers by this summer. To complete the work, we’re calling on nearly 200 qualified state workers from across state agencies. 

FACT: In 2025, we worked closely with CMS to assess the Housing Stabilization Services program and ultimately closed it down.

In 2025, we worked closely with CMS to assess the Housing Stabilization Services program and ultimately closed it down. At their recommendation, we disenrolled nonactive providers from 14 high-risk programs, and now regularly disenrolling providers who have not submitted billing for 12 months. Just before submission of our corrective action plan CMS approved our plan to pause new provider enrollments while we review our processes.

FACT: CMS’s own data released in January shows Minnesota has a payment error rate well below the national average.

CMS’s own data released in January shows Minnesota has a payment error rate well below the national average.

FACT: We have done everything CMS has asked of us.

In short, we have done everything CMS has asked of us. Minnesota will continue our commitment to leading the nation in our efforts to prevent and stop Medicaid fraud.

FACT: CMS’ actions here put Minnesotans at risk of losing lifesaving and life changing assistance.

DHS and CMS partner to provide services to vulnerable Minnesotans. CMS’ actions here put Minnesotans at risk of losing lifesaving and life changing assistance. DHS remains willing to work with CMS and we hope for the same from our federal partners.

Minnesota has a zero-tolerance stance on fraud and is now a national leader in fraud prevention and detection. Check out our work and let us know who’s doing it better!

• Identified 14 Medicaid services as high-risk and:
  • Established a freeze on adding new service providers in those programs
  • Implemented a new third-party review of claims before they are paid
  • Discontinued the Housing Stabilization Services program
  • Audited autism service providers, included on-site visits
  • Disenrolled inactive providers 
  • Expanded the use of analytics to prioritize review of payments before and after they are made
• Implementing licensures for autism centers
• Developing enhanced training for providers and state employees who work on Medicaid provider training and education
• Developing additional training for state employees who work on Medicaid
• Planning systems for increased oversight of large health care providers providing managed care services
• Conducting onsite visits and revalidating over 5,800 Medicaid providers before this summer