By REP. Kristin Robbins
Last week the Office of the Legislative Auditor (OLA), the well-respected, non-partisan state office tasked with promoting accountability in state programs, released their review of the Department of Human Services’ (DHS) overpayments to two Minnesota tribes for opioid treatments. The level of mismanagement, lack of meaningful accountability, and absence of processes or internal controls detailed in the report are alarming and unacceptable.
As a reminder, it was reported in July that DHS had overpaid the White Earth and Leech Lake tribes for opioid treatment programs by $29 million. DHS had misinformed the tribes that they could charge $455 for face-to-face appointments when the patients were actually self-administering opioid treatment medication at home. These overpayments are in violation of federal Medicaid laws and the State is required to repay the $29 million to the federal government.
Further, the OLA was not able to find any DHS official, past or present, who took responsibility for authorizing these rates or payments. The OLA summed it up best: “...the fact that DHS officials did not stop the payments and allowed them to continue for several years indicates a level of mismanagement and dysfunction within DHS that is extremely troubling.”
Unfortunately, these overpayments may be just the tip of the iceberg. In addition to these tribal overpayments, the OLA discovered that DHS has also been making unauthorized payments to non-tribal providers for self-administration of take-home medications at the rate of $23 per day. The DHS official responsible for Medicaid payments said she believes this controversy is “only one example” of issues with payments through Medicaid.
It is clear from the report that DHS – not the providers or taxpayers – is at fault for these overpayments. The Legislature absolutely should not give DHS any additional funds to cover their mistakes. Instead, they should have to do what Minnesota families and businesses have to do when they make mistakes or have a shortfall – cut budgets and find ways to save money.
The issues uncovered by the OLA report are serious and indicate that larger problems may yet exist. Since the summer, DHS has multiple resignations and reinstatements of top leaders without any public explanation for this leadership turmoil. There has also been more than $80 million in improper or fraudulent payments across various divisions; accusations of retaliation against whistleblowers; and clear examples where they have acted without statutory authority.
I met with DHS Commissioner Harpstead last week and believe she is committed to implementing rigorous internal controls to prevent misuse of taxpayer money. I look forward to working with her to develop legislation that clarifies the limits of the department’s authority. Meaningful solutions require understanding the scope of the problems and we cannot do our job of providing oversight if we are not able to talk to the people who have direct knowledge of these programs and events. I also continue to join my colleagues in calling for a full, independent audit of DHS. This is the only way for us to understand the full extent of problems and provide the accountability the department seems unable or unwilling to provide.
DHS is our state’s largest agency and it serves our most vulnerable citizens. We all have a stake in its success and I hope to work with the Commissioner, the many professional employees of the department and my colleagues to bring reform, accountability and top-quality management techniques to the Department to ensure it runs efficiently and effectively.
Representative Kristin Robbins, serving House District 34A - Maple Grove, Dayton, and Rogers