This bill aims to enhance oversight and accountability within the medical assistance program 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 subdivision that mandates the commissioner to conduct background studies for all controlling individuals and managerial officials of vendors receiving reimbursement through the medical assistance program. 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 fraud detection system that the commissioners of human services and children, youth, and families must establish. 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, ensuring ongoing oversight and improvement of the system.

Statutes affected:
Introduction: 245C.03, 256.983