This bill aims to enhance oversight and accountability within the medical assistance program in Minnesota by implementing background checks for medical assistance vendors and establishing a fraud detection system. Specifically, it amends Minnesota Statutes 2024, section 245C.03, by adding a new subdivision that mandates the commissioner to conduct background studies for all controlling individuals and managerial officials of vendors receiving medical assistance reimbursements. Vendors must comply with these background study requirements and demonstrate that individuals subject to the studies are either not disqualified or have received a set-aside of disqualification.

Additionally, the bill amends Minnesota Statutes 2024, section 256.983, to introduce a new subdivision that requires the commissioners of human services and children, youth, and families to create an automated or semi-automated fraud detection system. This system will review vendor payments for suspicious or potentially fraudulent activity, with fraud investigators tasked to examine flagged payments. Furthermore, the commissioners are required to analyze the effectiveness of the fraud detection system periodically and report their findings to relevant legislative committees.

Statutes affected:
Introduction: 245C.03, 256.983