(ABC 6 News) — Fraud has been a hot-button issue in Minnesota for years, beginning with the Feeding Our Future scheme before other accusations were made of widespread fraud in several state programs.
In December, those allegations were thrust into the national spotlight after a video of a YouTuber investigating fraud in the state went viral.
Since then, there has been a statewide crackdown on Medicaid fraud, which is something autism clinics across Minnesota say has caught them in the crossfire.
In Rochester, one nonprofit serving hundreds of families told ABC 6 News the uncertainty alone could be devastating.
“Ultimately, this is not a long-term solution for us. There is no way we can continue at the current trend moving forward,” said Bryan Jarcho, the regional operation director for MAC Midwest.
MAC Midwest is a nonprofit autism service provider with 18 centers across Minnesota. It serves about 300 families statewide with a waitlist that continues to grow.
The care they provide depends heavily on Medicaid reimbursement, and providers say these payments are now unpredictable and delayed amid the fraud crackdown.
“As it stands, we are owed a significant amount of payments for services that we have provided,” Jarcho said.
The delays stem from a new Medicaid prepayment review process, which was one of the programs Minnesota rolled out as a broader effort to combat fraud.
Under the process, certain claims are suspended and reviewed before payment — a process that has caused significant delays compared to they usual roughly two-week payment cycle.
That push has come even as new federal data shows Minnesota’s Medicaid improper payment rate is 2.16%, which is well below the national average of 6.1%.
“We’re really supportive of the idea of of getting after fraud, waste and abuse — not at the expense of families and kids of Minnesota. It’s just not acceptable,” said Jarcho.
For families, the impact is immediate.
Elizabeth Walby leads to Rochester Area Autism Association, and she says consistent support and therapy from providers helped her daughter, who does not communicate with words, succeed in a classroom with other students. She worries this could now be out of reach for some families.
“It can be a really hopeless, you know, feeling, not having the support available that you have been told your child needs,” said Walby.
Due to the lack of payments, MAC has had to put a pause on hiring new staff and currently faces a shortage of resources.
However, providers say cutting services isn’t an option because consistency is critical for children with autism.
However, without clearer communication and reliable payments, they say time may be running out.
“We will go until we can’t,” said Jarco.
Staff at MAC Midwest also say they need clearer guidance from state and federal leaders and are urging community members to contact their legislators about the impact these delays are having on families.