SF 4222 Minnesota Senate · 2025-2026 Regular Session

Medical assistance provider enrollment requirements modifications

This bill modifies enrollment requirements and program integrity rules for medical assistance providers in Minnesota. It directs the commissioner of human services to establish an advisory board, update provider enrollment standards, and conduct audits to improve oversight of the medical assistance program. The legislation expands the commissioner's authority to impose sanctions on providers who engage in fraud, abuse, or billing errors, and clarifies that no criminal conviction is required before sanctions can be applied. Additionally, the bill requires the commissioner to consider the severity of misconduct when determining penalties and mandates specific reporting requirements.

Issues: ✓ Healthcare

Bill status in committee 1 of 4 stages cleared

Introduction

Mar 2026

Committee Review

Floor Vote

Governor

Introduced Mar 9, 2026 Last action Apr 7, 2026

Maddy AI version diff · 2 comparisons

What changed between versions

1st Engrossment → 2nd Engrossment · 3 edits · Apr 7, 2026

MINOR

The bill was updated from the 1st to the 2nd Engrossment, primarily involving a significant reorganization of the legislative text structure. The most notable substantive change is the deletion of a large section of the original bill (Sections 1 through 6) that detailed specific program integrity requirements, sanctions, and exemption clauses for the medical assistance program. While the document now includes many new section numbers, the provided text does not contain the actual legal content for these new sections, making it impossible to determine if new policies were added or if the bill was effectively stripped of its core provisions in this version.

Scope change

The bill's scope appears to have been drastically reduced or completely rewritten, as the detailed statutory amendments and enforcement mechanisms present in the 1st Engrossment were removed without replacement text in the 2nd Engrossment.

REQUIREMENT

Deleted specific statutory amendments regarding exemptions for the medical assistance program and detailed grounds for sanctions against providers.

ENFORCEMENT

Removed provisions detailing the process for imposing monetary recoveries, fines, and suspending provider participation in the program.

TECHNICAL

Reorganized the document structure by replacing detailed legal text with a sequential list of new section numbers (e.g., 1.25 through 45.31) without providing the content for those sections.

Introduction → 1st Engrossment · 6 edits · Mar 26, 2026

MODERATE

The bill was updated from its introduction to its first engrossment, reflecting significant substantive changes to Minnesota's medical assistance program integrity laws. The primary focus is on strengthening fraud prevention by adding new enforcement tools, such as the ability to withhold payments without prior notice for credible fraud allegations and imposing stricter sanctions. The bill also expands provider enrollment requirements, mandating cash reserves and unannounced site visits, while clarifying exemptions for certain entities.

Scope change

The bill's scope expanded to include new enforcement mechanisms and stricter enrollment requirements for all medical assistance providers, while also clarifying that certain individuals and entities (like banks and low-share owners) are excluded from 'controlling individual' definitions.

ENFORCEMENT

The commissioner can now withhold or reduce payments immediately without prior notice if there is a credible allegation of fraud under investigation, whereas previously advance notice was generally required.

New provisions allow the commissioner to order individuals or entities to forfeit fines related to incomplete documentation, with fines capped at 20% of claims paid or $5,000.

REQUIREMENT

New requirements mandate that providers maintain cash reserves of at least $100,000 or 10% of their Medicaid revenue from the previous year to ensure financial viability.

Providers must now allow for unannounced site visits by state or federal agents at specific intervals, including before the first claim payment and within 12 months of billing.

DEFINITION

The definition of 'controlling individual' was modified to explicitly exclude individuals who own less than five percent of a corporation's shares if those shares are exempt under specific securities laws.

TIMELINE

The timeline for provider revalidation was adjusted, reducing the notice period for termination from 60 days to 15 days if a provider fails to remedy deficiencies.

Floor votes

How they voted

No floor votes recorded yet.

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Apr 7, 2026

Committee

Comm report: Amended, No recommendation, re-referred to Finance

upper

Mar 26, 2026

Committee

Comm report: Amended, No recommendation, re-referred to Human Services

upper

Mar 9, 2026

Committee

Referred to Health and Human Services

upper

Mar 9, 2026

Introduced

Introduction and first reading

upper

1 primary · 3 co-sponsors