state-commissioned review unveiled Friday confirms what KARE 11 Investigates has been uncovering for years: Minnesota’s Medicaid system had widespread vulnerabilities that allowed questionable billing to go undetected—costing taxpayers tens of millions of dollars and exposing the program to far greater losses.
The vulnerability assessment, conducted by the data analytics firm Optum, reviewed nearly four years of fee-for-service Medicaid claims across 14 programs the Minnesota Department of Human Services (DHS) designated as high risk. The analysis covered claims from January 2022 through October 2025 and examined roughly 20 percent of the state’s Medicaid billing.
The findings point to systemic weaknesses in oversight, billing rules and enforcement as Optum's report found vulnerabilities across all 14 programs.
The 14 high-risk Medicaid services are as follows:
- Housing Stabilization Services (HSS)
- Peer Recovery Support Services (PRSS)
- Early Intensive Developmental and Behavioral Intervention (EIDBI)
- Integrated Community Supports (ICS)
- Non-Emergency Medical Transportation (NEMT)
- Adult Rehabilitative Mental Health Services (ARMHS)
- Personal Care Assistance/Community First Services and Supports (PCA/CFSS)
- Adult Day Services (ADS)
- Recuperative Care (RS)
- Individualized Home Supports (IHS)
- Adult Companion Services (ACC)
- Night Supervision (NS)
- Assertive Community Treatment (ACT)
- Intensive Residential Treatment Services (IRTS)
