Minnesota’s efforts to keep people covered while addressing Medicaid fraud were central to discussions at the September 30, 2026, Health Policy Conference in Minneapolis. Hosted by State of Reform, an HMA company, the conference brought together lawmakers, state officials, providers, community-based organizations, and policy experts to discuss the healthcare landscape. Specific topics covered included how to respond to the 2025 budget reconciliation legislation (commonly referred to as OBBBA or the Working Families Tax Cut Act [WFTCA]) and address fraud, waste, and abuse (FWA) without disrupting coverage or weakening provider capacity.
Particularly for the Medicaid program, discussions connected immediate implementation decisions with how healthcare leaders could introduce more accountability into the program without making healthcare harder to access or weakening an already strained delivery system.
Key Discussions: Coverage, Oversight, and Continuity of Care
Federal Medicaid changes put pressure on coverage continuity.
An estimated 140,000 Minnesotans could lose Medicaid coverage as provisions of the WFTCA take effect, including work requirements, six-month redeterminations, and cost-sharing for the expansion population, and coverage changes affecting some lawfully present immigrants. State lawmakers, including Sen. Alice Mann, Vice Chair of the Health & Human Services Committee, and Rep. Mohamud Noor, Co-Chair of Human Services Finance & Policy, shared their concerns about the coverage losses and steps they are taking to soften the effects; for example, requiring a one-month lookback period for the work requirements instead of three.
Discussions at the conference also made clear that Minnesota leaders are focused on how people experience Medicaid changes in practice. Representative Noor emphasized the need for practical support, including guidance around work requirements, help for people who qualify for emergency medical assistance, and attention to people in long-term care. He also stressed the importance of keeping counties involved because they will experience much of the operational and financial impact of federal policy changes.
In Minnesota, the state can set policy and build eligibility systems, but counties, health plans, providers, and community organizations are the ones that recognize when someone is at risk of losing coverage. Former Minnesota Department of Human Services Deputy Commissioner Chuck Johnson suggested that, as Minnesota implements federally required eligibility changes, it should also think about redesigning the eligibility process itself and using the federally-driven eligibility changes as an opportunity to make the state’s system easier to navigate.
Program Integrity Activities Earlier
Minnesota’s Medicaid fraud concerns have brought greater scrutiny to how the state manages providers and protects public funds. In December 2025, the Centers for Medicare & Medicaid Services (CMS) requested a corrective action plan (CAP) to address concerns regarding FWA within the state’s public benefits programs. The Minnesota Department of Human Services (DHS) submitted a CAP on December 31, 2025 and CMS approved a revised version of the plan March 19, 2026. The state’s response has included revalidating high-risk Medicaid providers, establishing a moratorium on new service providers in certain high-risk areas, creating a public program integrity dashboard, and discontinuing the Housing Stabilization Services benefit. Minnesota also secured funding to expand DHS’s program integrity workforce by more than 400 positions over two years.
Speakers at the conference agreed that addressing those problems also means helping providers build stronger operations. Mr. Johnson acknowledged both the fraud that needs to be stopped and the politically charged perceptions surrounding it. He also encouraged offering support to providers so they can improve integrity within their own operations.
That emphasis on prevention carried into the discussion with Health Management Associates (HMA) Associate Principal Jen Bridgeforth and Regional Director Clint Eisenhower. Both focused on the work that happens before an improper payment is made—from everyday compliance practices within provider organizations to the way states design programs.
Written compliance procedures, staff with the right expertise, and technology that supports oversight can help organizations identify risks earlier. Ms. Bridgeforth emphasized that responsibility extends across an organization. Those safeguards take time and money, she noted, but the administrative burden and costs increase substantially when audits uncover fraud. Mr. Eisenhower connected that day-to-day work to policy decisions, adding that program integrity needs a place in program design.
Speakers also emphasized that Minnesota’s anti-fraud efforts should account for what happens to people receiving care, noting, for example, ongoing behavioral health provider capacity gaps and the risk of deepening access challenges. This theme of involving providers in discussions extended into conversations about medical respite, homelessness, and complex discharge where problems have emerged when healthcare and community systems are misaligned.
The Bottom Line: Practical Solutions, Collaboration, and Shared Responsibility
The key takeaway from the conference was that Minnesota’s healthcare coverage and delivery system challenges require practical solutions. These efforts should focus on: 1) cross-sector approaches to helping people retain Medicaid coverage, 2) a more systematic statewide approach to program integrity, and 3) new initiatives to improve complex discharge for children and adults, which could provide lessons for broader policy change.
Another theme that emerged across sessions was the need for shared responsibility in designing, implementing, and sustaining responses to changes and pressures stemming from the WFTCA, as well as other pressures on the healthcare system. This coordinated response calls for respecting each other’s unique roles and perspectives while recognizing the interconnected nature of the work. For example, Minnesota counties will need support from the state as Medicaid eligibility requirements change. Health plans, providers, and community organizations can reach people before administrative issues turn into coverage losses. State program integrity officials can work with providers to identify vulnerabilities upstream instead of relying primarily on audits after payments have been made. Hospitals, behavioral health providers, housing organizations, and community partners can build clearer pathways for people who otherwise become caught between systems.
Looking Ahead
If you are looking for strategies and solutions to address urgent healthcare policy and operational challenges, HMA experts are available to help you identify practical paths forward.
Through the HMA National Conference, State of Reform partnership events, and other HMA convenings across the country, we connect state leaders, providers, health plans, and community stakeholders to share insights, elevate lessons, and advance solutions. Join us at one of our next SOR events—November 10, 2026, in Raleigh, NC, or November 17, 2026, in Chicago, IL—or explore additional opportunities to engage with HMA and access the full schedule of conferences and resources.
State of Reform develops its conference agendas through collaboration with HMA subject matter experts/market leads and stakeholders across the public and private sectors, including state officials, community-based organizations, providers, payers, and more.