Bill to release unredacted Optum report on Medicaid fraud moves forward

Brandishing a completely blacked-out page of a long-anticipated third-party audit of the state’s Medicaid system, Rep. Jeff Backer (R-Browns Valley) asked: “How in the Sam-heck can we do our job if we don’t get this information?”

The heavily redacted report by Optum was the focus of a Wednesday House Human Services Finance and Policy Committee meeting. Legislators questioned the integrity of the report’s findings and asked why they could not access the report in its entirety.  

The report, a comprehensive evaluation of fraud, waste, and abuse across 14 high-risk services and programs, showed, in part, stronger policies and prepayment safeguards could save more than $1 billion.

Rep. Joe Schomacker

Sponsored by Committee Co-Chair Rep. Joe Schomacker (R-Luverne), HF3378 would require the release of the unredacted initial Optum reports. Approved by the committee, the bill’s next stop is the House Judiciary Finance and Civil Law Committee in a voice vote. 

John Connolly, deputy commissioner and state Medicaid director at the Department of Human Services, said he understands the frustration over the redacted report.

Those with full access to the report include the Office of the Legislative Auditor, the federal Centers for Medicare and Medicaid Services, DHS officials and Gov. Tim Walz. However, under the Minnesota Government Data Practices Act, legislators are treated like the public when it comes to their access to “security and proprietary” data, Connolly said.

Department officials recognize the need for legislators to have as much information as possible when it comes to decision making, he added. This could lead to the release of additional information in the future.

“In the interest of transparency, the release of the report was hours after receiving the deliverable from Optum,” Connolly said. “So, this was a very quick process in perspective to redactions. We are taking another close look at the document to see what information we can release to legislators.”

Some legislators also voiced concerns about the report itself, and the process taken to procure it.

Rep. Brion Curran (DFL-White Bear Lake) and Rep. Luke Frederick (DFL-Mankato) noted that the audit’s third-party vendor, Optum, is a subsidiary of UnitedHealth Group, a company that has faced its own fraud allegations. Other legislators voiced concerns over Optum’s use of artificial intelligence in gathering data.

“You don’t know what you don’t know and this was an effort to try to identify the things that you don’t know,” Schomacker said in closing.