MN ADC 9505.0131

Wrongfully Obtained Assistance

A local agency that receives information that a person may be wrongfully obtaining medical assistance benefits under Medicaid must do the following:

1. The local agency must refer the individual to a local fraud investigation unit;
2. The local agency must issue a notice reducing or terminating the individual’s medical assistance eligibility;
3. If the investigation shows the local agency that fraud has occurred, the agency must refer the individual to the county attorney.

The local agency must collect and report on statistical information as required by the Commissioner of Human Services on ways of preventing people from wrongfully obtaining assistance.