Medicaid Payments Frozen for 14 ‘High-Risk’ Programs

By Jasmine Laws / October 30, 2025

Minnesota Governor Tim Walz has announced that payments for 14 different Medicaid services will be frozen for up to 90 days while a third-party audit is conducted to investigate possible fraud.

On Wednesday, the governor announced that these services were "high-risk" programs based on "programmatic vulnerabilities, evidence of fraudulent activity, or data analytics that revealed potentially suspicious patterns, claim anomalies, or outliers."

Why It Matters

This comes after hundreds of Medicaid providers in Minnesota - around 800 - were disenrolled from the state’s Medicaid program as part of the Minnesota Department of Human Services' increased action against systemic fraud.

The decision fell in line with Walz's Executive Order 25-10, which is about "empowering state agencies to continue combating fraud."

How the federal health program Medicaid operates and is funded has come into the spotlight since the start of President Donald Trump's second term, as his administration vowed to removed “waste, fraud and abuse” from the system.

What To Know

The 14 services identified as "high-risk for billing irregularities or fraud" include:

• Early Intensive Developmental and Behavioral Intervention services for autism

• Integrated Community Supports

• Nonemergency Medical Transportation

• Peer Recovery Services

• Adult Rehabilitative Mental Health Services

• Adult Day Services

• Personal Care Assistance/Community First Services and Supports

• Recuperative Care

• Individualized Home Supports

• Adult Companion Services

• Night Supervision

• Assertive Community Treatment

• Intensive Residential Treatment Services

• Housing Stabilization Services

In order to "detect suspicious billing activity and scrutinize the use of public funds," payments for these services will be paused for the 90 day period, the announcement said.

The Minnesota Department of Human Services (DHS) told Newsweek that a payment will "only be paused for up to 90 days if an anomaly is detected and needs to be reviewed further." They added that "if the review determines the bill is fraudulent, it will not be paid."

The governor's office also said the DHS had partnered with Optum, which will analyze Medicaid fee-for-service claims data and flag potential issues for review.

As the third-party vendor reviewing claims, Optum will be looking specifically for "irregularities such as missing documentation, unusually high billing patterns, or inconsistencies suggesting that a claim may not meet program requirements."

Walz's office said that this "new layer of review will safeguard Medicaid dollars before payments go out."

Any claims suspected to be "improper" will be referred to the agency’s Office of Inspector General for review and possible investigation, the office said.

As a result of the audit, it may take longer for providers to be paid for services, while their claims undergo review, but the state will ensure payments are made within 90 days.

Services which are deemed "high-risk" will also be subject to "stricter oversight requirements, including mandated enhanced fingerprint background studies for owners of provider agencies, initial screening visits and unannounced site visits," the governor's office added.

What People Are Saying

Minnesota Governor Tim Walz said in a statement on Wednesday: “We cannot effectively deliver programs and services if they don’t have the backing of the public’s trust. In order to restore that trust we are pumping the brakes on 14 programs that were created to help the most disadvantaged among us, yet have become the target of criminal activity. If you attempt to defraud our public programs and steal taxpayer dollars out from under the people who need them most – you will be stopped, and you will be held accountable.” 

Temporary Human Services Commissioner Shireen Gandhi said in a statement on Wednesday: “We’re taking a systematic approach to finding and stopping fraud. Adding outside review before payments go out and increasing safeguards for these high-risk services will preserve resources necessary to serve Minnesota’s children, people with disabilities and older adults.” 

What Happens Next

Minnesota's Medicaid providers, and their handling of services and claims, are likely going to continue to be scrutinized by the Department of Human Services, following the direction of Walz' executive order on combating fraud in the system.