CMS chief warns Minnesota: fix Medicaid fraud or lose funds
CMS Administrator Dr. Mehmet Oz issued a 60‑day ultimatum to Minnesota on Dec. 5, warning Gov. Tim Walz that the federal share of Medicaid payments could be halted unless the state implements anti‑fraud fixes and submits a corrective action plan. Oz cited alleged theft exceeding $1 billion tied to "bad actors" in the Somali community, flagged suspicious spending spikes in Housing Stabilization Services and autism‑related EIDBI programs, and demanded weekly updates, a six‑month enrollment freeze for high‑risk providers, and re‑verification of all current providers.
📌 Key Facts
- Deadline: 60 days for Minnesota to deliver weekly anti‑fraud updates, freeze high‑risk provider enrollment, re‑verify providers, and submit a corrective action plan.
- Threat: CMS may stop paying the federal share of Minnesota Medicaid if plans or cooperation are unsatisfactory.
- Program figures cited: Housing Stabilization Services paid $100M+ in 2024 vs. $2.6M projected; EIDBI rose from $3M (2018) to nearly $400M (2023).
📊 Relevant Data
Approximately 107,000 people of Somali descent lived in Minnesota in 2023, representing about 2% of the state's total population of around 5.7 million.
By the numbers: Minnesota's Somali population, according to census data — KTTC
About 36% of Somali Minnesotans lived below the poverty line from 2019 to 2023, compared to the U.S. poverty rate of 11.1% during the same period.
Minnesota's beleaguered Somali community under a cloud of fraud — WHMI
In 2020, the autism spectrum disorder prevalence among Somali 8-year-old children in Minnesota was 1 in 32, compared to 1 in 36 for White children and an overall rate of 1 in 34.
Autism Spectrum Disorder (ASD) Prevalence in Somali Children in Minnesota: 2020 Surveillance Year — INSAR
In 2020, 1 in 16 Somali preschool children in Minnesota were diagnosed with autism, compared to an overall rate of 1 in 53 for 4-year-olds.
Minnesota autism summit helps Somali parents find support — Sahan Journal
Somali Minnesotans generate at least $500 million in income annually and pay about $67 million in state and local taxes, with a median household income of $28,500.
Somali Minnesotans drive economic growth, pay $67M taxes annually — KSTP