Overview
- The administration announced the deferrals on Tuesday, holding about $867.5 million for California and roughly $199 million for Minnesota while federal reviews continue.
- CMS said the reviews found unsupported or high‑risk claims in specific areas, including certain in‑home services in California and 14 service categories in Minnesota.
- Minnesota has started submitting records that federal officials are reviewing, while CMS describes the California issues as broader and more complex.
- HHS officials said they used advanced analytics and artificial intelligence to find anomalies and that the agency will expand its power to exclude suspected fraudsters from federal health programs.
- Officials and analysts warn the pause could delay provider payments and services for beneficiaries because federal matching funds are withheld, and the action follows wider DOJ and HHS fraud investigations that have produced large indictments and past payment deferrals.