A Tale of Two Medicaid States: Minnesota Fraud vs. Indiana Reform

More indictments in Tim Walz’s state, while Mike Braun’s reforms save hundreds of millions of dollars

WSJ editorial. Excerpts:

"fraud losses since 2018 could top $9 billion."

"two men in Philadelphia . . . registered as housing providers despite no connections in the state. Minnesota was the first state to let Medicaid funds be used for housing services for the disabled and recovering addicts. The defendants billed Medicaid for fake services."

"This is a pattern in the charges: Defendants set up sham companies, then submitted false claims."

"the home-care program “has been vulnerable to fraud,” as providers can bill the state for providing care up to 24 hours a day. Minnesota Medicaid spending on this in-home program surged to $170 million in 2024 from $4.6 million in 2021"

"The state’s Medicaid spending has increased by nearly two-thirds in six years."

"Medicaid spending nationwide has increased by some $380 billion since the beginning of the pandemic"

This "spurred Indiana Republicans this spring to impose reforms, including more rigorous eligibility checks and guardrails to prevent excessive billing."

"the state said it expects to save $466 million on Medicaid over the next two years compared to its spring projections. Medicaid enrollment has declined by some 11% thanks to eligibility checks."

"the 340B program, which lets hospitals and pharmacies they contract with buy drugs as steep discounts. They then charge insurers large markups when they administer the drugs to patients."