Department of Human Services official talks program integrity updates

Across party lines, House members agree that those responsible for mass fraud in the state must be held accountable.

For many, this includes the Department of Human Services for any lapse in oversight.

The House Human Services Finance and Policy Committee heard an update on the department’s program integrity Thursday from Kristy Graume, its director of state government relations.

Medicaid, called Medical Assistance in Minnesota, is the largest single source of health insurance in Minnesota, serving over 1 million Minnesotans and covers 40% of the state’s children.

Graume’s presentation focused on transparency, prevention, detection and enforcement around fraud, saying these are necessary steps to help people who rely on Medicaid the most. It also detailed how laws passed in 2025 will allow the department to further identify, track and report fraud within systems.

[MORE: View the presentation]

One law included policies like the establishment of the “midpoint rule,” which clarifies federal reimbursement guidelines for substance use disorder programs. New laws also require new training for owners and managers of service programs and prohibit kickbacks for Medical Assistance.

There are only a few bad actors within programs identified to be susceptible to fraud, Graume said, but they ultimately hurt honest providers and patients alike. “It’s even challenging to talk about it because we don’t want to cast shade over those good providers who comprise most of the Medicaid system.”

Rep. Tom Murphy (R-Underwood) and Rep. Brion Curran (DFL-White Bear Lake) both asked why no one with the department was fired as continued instances of fraud were uncovered over the past year.

“I think what Minnesotans are asking for is a little bit of acknowledgment of accountability on the state’s part in all of this,” Curran said.

Co-Chair Rep. Mohamud Noor (DFL-Mpls) said more department leaders will be available to answer committee member questions at a future date.