News
Minnesota appeals federal decision to withhold Medicaid funding
6+ hour, 25+ min ago (537+ words) Minnesota is seeking to stop the U.S. Centers for Medicare and Medicaid Services (CMS) from withholding funding that helps low-income and higher-risk residents and families obtain proper health care. CMS has accused the state of being "substantially out of compliance with…...
Optum begins Minnesota Medicaid audit with 80K ‘high-risk’ claims
2+ week, 1+ day ago (403+ words) The Minnesota Department of Human Services (DHS) has begun "enhanced prepayment review" of Medicaid service programs, according to an update from state officials on Monday. More than 80,000 claims have been sent to UnitedHealth Group subsidiary, Optum, marking the first round…...
Clock is ticking for Minnesotans depending on health insurance subsidies
1+ mon, 3+ day ago (537+ words) With the clock ticking toward a health insurance application deadline, Minnesotans are dealing with a lot of unknowns. They have until Dec. 15to apply for health insurance for 2026 on the public market that would begin in January.However, they likely won't…...
Minnesota seniors are feeling the squeeze as Medicare premiums rise
1+ mon, 3+ week ago (275+ words) More than a million Minnesota seniors are enrolled in Medicare. Many are feeling a financial squeeze as premiums rise. 2026 prices, just out from the federal government, show Medicare Part B " which covers visits to the doctor and preventative care " show…...
UCare's health contracts sold to Medica; 300,000 Minnesotans impacted
1+ mon, 3+ week ago (209+ words) UCare announced more than 300,000 people will transition to Medica, under a new deal between the two Minnesota nonprofit health plans. The news comes after UCare previously announced it's ending its Medicare Advantage plans next year. UCare says, under the agreement,…...
While subsidy debate continues, consumers face health insurance sticker shock
2+ mon, 2+ day ago (394+ words) Huge increases in health insurance costs for thousands of low and middle-income Minnesotans won't discriminate based on whether you're a Republican or Democrat. Everyone in the MNsure public marketplace will be subject to premium increases that could be double, triple…...
An emerging shutdown deal doesn't extend expiring health subsidies. Here's what could happen to them
2+ mon, 4+ day ago (780+ words) The deal agreed to by Senate Republicans and a handful of Democrats on Sunday instead only guarantees a December vote on the enhanced premium tax credits, which are set to expire at the end of the year without congressional action....
Questions surrounding choice for Minnesota Medicaid auditor
2+ mon, 1+ week ago (323+ words) 5 EYEWITNESS NEWS is taking a closer look at why the State of Minnesota selected Optum as its third-party auditor for Medicaid billing. It is a $2.3 million contract for "pre-payment review" this year, amid investigations into possible fraud in 14 Medicaid programs…...
Providers concerned as Minnesota Medicaid audit may delay payments
2+ mon, 1+ week ago (335+ words) Minnesota Gov. Tim Walz's office announced on Wednesday that claims for 14 Medicaid services will be audited by a third party, potentially delaying payments to providers by up to 90 days. The auditing is being done through Optum, a division of Minnetonka-based…...
MNsure open enrollment starts Saturday with spike in premiums
2+ mon, 1+ week ago (351+ words) Minnesotans who buy their health insurance through MNsure, the state's public marketplace, will likely get sticker shock when they see the increase in premiums. For the individual market, premiums are up on average 21.5% with an increase of 14.2% for small group…...