HHS Defers More Than $1 Billion in Medicaid Payments To California & Minnesota Pending Review Of High-Risk Claims For Fraud

The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) announced that it would defer more than $1 billion in federal Medicaid payments to California and Minnesota as part of the new federal approach to prevent fraud, waste, and abuse. HHS and CMS demanded that the two states submit additional documentation to support what CMS alleges are high risk Medicaid claims. CMS withheld $867.5 million from California and $199 million from Minnesota.

CMS said it imposed a deferral because “focused financial reviews identified claims that require additional review” before federal . . .