Starting June 1, the Minnesota Department of Human Services (DHS) will increase oversight of providers delivering autism and housing services through Medicaid. The move, which reclassifies these services as “high risk,” is part of a broader initiative to strengthen fraud prevention and ensure quality care for vulnerable populations.

New Oversight Begins

The updated screening requirements apply to providers billing Medicaid for Early Intensive Developmental and Behavioral Intervention (EIDBI) autism services and Housing Stabilization Services, which support older adults and people with disabilities in finding and keeping housing. Both services will be recategorized as “high risk.”

Stronger Protections for Minnesotans

“It’s clear that these critical services need more oversight,” said interim Human Services Commissioner Shireen Gandhi. “Moving these providers into the high-risk category is only the first step. We need more staff to put eyes on these programs and make sure everyone is safeguarding resources meant to help children, people with disabilities, and older Minnesotans.”

Enhanced Screening Measures

By reclassifying these services, Minnesota gains the authority to enforce stricter federal Medicaid screening protocols. These include:

• Fingerprint-based background checks for owners
• Mandatory site visits before enrollment and at revalidation
• Permission for unannounced inspections by DHS

Federal Risk Categories Explained

The federal government defines three provider risk levels: limited, moderate, and high. Until now, autism services fell under “moderate risk,” while housing services were “limited risk.” Minnesota’s decision moves both into the high-risk category, allowing for increased scrutiny.

Fraud Prevention a Priority

Governor Tim Walz’s budget proposal includes additional strategies to combat Medicaid fraud. These efforts involve:

• Expanding DHS staff
• Deploying advanced technology for fraud detection
• Strengthening investigative powers and enforcement
• Tightening regulatory controls across high-risk programs

Support and Reporting Encouraged

DHS acknowledged that most providers work diligently to serve their communities and encouraged them to seek technical help during the transition. Anyone who suspects fraud or abuse of Medicaid funds can report it by calling the DHS integrity hotline.