Purpose of the Bill

The bill aims to enhance the integrity of the medical assistance program in Minnesota by introducing mandatory background checks for certain vendors and establishing a system to detect fraud in vendor payments.

Main Provisions

• Background Checks for Vendors: The bill requires background checks for all controlling individuals and managerial officials of vendors that receive reimbursements through the medical assistance program. These individuals must not be disqualified under existing law, or must have received a set-aside of disqualification for eligibility for medical assistance payments.

• Fraud Detection System: The bill mandates the creation of an automated or semi-automated system for detecting fraudulent activities within vendor payments. Any suspicious, unusual, or potentially fraudulent vendor payments identified by this system must be reviewed by fraud investigators.

• Reporting and Analysis: The commissioners of human services, and children, youth, and families must periodically analyze the fraud detection system's efficiency and effectiveness. The results must be reported to legislative committees overseeing human services.

Significant Changes to Existing Law

• The bill introduces a new requirement for background studies specifically targeting individuals associated with medical assistance vendors who were previously not covered under the specific requirements of section 245C.03.
• It adds a new subdivision to section 256.983, creating a structured process for detecting and reviewing potentially fraudulent activities in vendor transactions under the Department of Human Services and the Department of Children, Youth, and Families.

Relevant Terms

• Medical assistance
• Background checks
• Fraud detection
• Vendor payments
• Human services
• Disqualification set-aside