Minnesota Medicaid Audit: What It Means for PCA, CFSS, and Homecare Providers and Clients
Beginning Dec. 1, 2025, DHS will audit Medicaid services. Accra will continue all caregiver pay and client care with no disruption statewide.
The Minnesota Department of Human Services (DHS) will begin a statewide payment review for homecare providers on December 1, 2025. Accra will continue operating without any interruption to client services or caregiver pay. While some agencies may experience financial strain during this period, Accra is financially strong and accepting new clients to ensure Minnesotans experience no disruption in care.
Minnesota’s Medicaid Audit Will Begin December 1
Beginning December 1, 2025, the Minnesota Department of Human Services (DHS) will begin a third-party audit of several Medicaid-funded services. DHS has contracted Optum to review 14 service categories. The services that Accra provides that are included in this audit are:
- Personal Care Assistance (PCA)
- Community First Services and Supports (CFSS)
- Night Supervision and Individualized Home Supports (both under 245D Waivered Services)
This audit aims to verify billing accuracy and ensure compliance with federal and state requirements. During this process, DHS will temporarily pause payments for these services while Optum completes pre-payment reviews. Although reviews may take up to 90 days, many clean claims will be processed within 30 days.
Will My Services or Payments Be Affected?
No. Accra clients and caregivers will not experience any disruption. We remain fully committed to supporting clients and caregivers, across all 87 counties in Minnesota.
Accra is financially strong and fully prepared to continue all caregiver payroll on time and maintain uninterrupted services throughout the state’s review period.
Clients will continue receiving the same level of care and support from their trusted Accra team, and all current Service Authorizations remain valid.
Why Is DHS Auditing Medicaid Services?
The audit, conducted by Optum, is designed to:
- Ensure Medicaid funds are used appropriately
- Confirm provider billing practices meet state and federal standards
- Strengthen long-term program integrity and sustainability
“Increased audits, verification, and oversight are expected in the months ahead. While this will create short-term strain for many homecare providers, it is a necessary step to protect taxpayer dollars and preserve funding for the people who truly need care,” says CEO Colin Raymond.
How to Navigate This Moment:
For Accra Clients, Families, and Caregivers:
You do not need to take any action. Your services and caregiver payments will continue without interruption through the state’s audit period.
If you know someone in the homecare or disability community who may be affected by these changes, please connect them with Accra. We’re here to ensure every Minnesotan continues receiving the care and support they need.
For Non-Accra Clients or Families Affected by Service Interruptions:
Some homecare agencies that rely on state reimbursements for payroll may face financial hardship during this review period.
If your current provider cannot continue services because of delayed payments, Accra can help ensure continuity of care for you or your loved one.
Our team is ready to support new referrals and service transitions immediately.
For Case Managers and Social Workers:
We understand this process adds complexity for your clients. Here is what to know:
- Reassure clients and families that Accra will continue all services and payments during the audit.
- Continue normal referrals — Accra is accepting new clients in all programs.
- Contact our team with any questions or to discuss client transitions.
Accra’s dedicated Intake teams are available to ensure no disruption in client care.
Accra’s Commitment During the Medicaid Audit
Here’s how we’re ensuring stability for everyone we serve:
- Caregiver payments will continue on time.
- Client services will remain uninterrupted.
- Compliance and billing accuracy will continue to meet the highest standards.
- Communication with DHS and Optum is ongoing to stay informed of updates.
Accra has the most forward-leaning compliance team in Minnesota, as we have eight full-time compliance professionals focused daily on preventing fraud, ensuring accurate documentation, and protecting the long-term viability of these services.
Our commitment remains the same: ensuring every Minnesotan can receive the high-quality care and support they deserve.
Last updated November 4th, 2025, following DHS and Optum audit announcement.
About Accra
Accra provides individualized homecare services and support to people and families across all 87 counties in Minnesota. By focusing on choice, independence, and high-quality care, Accra helps people with care needs live safely and comfortably, while strengthening the broader homecare system. Learn more at www.accrahomecare.org.