WASHINGTON — The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) today deferred more than $1 billion in federal Medicaid payments to California and Minnesota as the states submit additional documentation supporting certain high-risk Medicaid claims.
CMS is deferring approximately $867.5 million in federal Medicaid payments to California and $199 million to Minnesota after focused financial reviews identified claims that require additional review before federal matching funds are released. These are payment deferrals (not permanent funding cuts) and both states will have the opportunity to provide documentation showing the claims meet federal Medicaid requirements.
Additionally, under Secretary Kennedy’s authority, HHS will be expanding its exclusion authority, enabling both CMS and the HHS Office of Inspector General to utilize this critical tool to remove bad actors from federal healthcare programs — and, in many cases, permanently bar them from returning.
CALIFORNIA
CMS reviewed California’s claims for certain in-home care programs after identifying spending growth that far exceeded national trends and other claims that require additional documentation. As a result, CMS is deferring approximately $867.5 million in federal Medicaid payments until the state provides the information needed to support those claims.
MINNESOTA
CMS also reviewed Medicaid claims in 14 high-risk service areas in Minnesota. The review identified claims that require additional documentation, including expenditures linked to providers flagged through program integrity reviews and other claims with potential eligibility or billing concerns. CMS is deferring approximately $199 million in federal Medicaid payments while that review continues.
