$1B
The state-commissioned Optum review’s estimate of payments needing closer review because of vague or missing payment policies. The report itself says the amount does not necessarily imply fraud.
Who reported it, and what it covers
reported February 6, 2026
January 2022 through October 2025 (46 months of claims)
The 14 high-risk Medicaid service types, $9.4 billion in claims reviewed
A review’s estimate of payments vulnerable to or needing review for problems. Explicitly not proven fraud.
What it does not show
Not fraud. The report says payments needing review because of unclear policies do not necessarily involve fraud, waste, or abuse.
What the source says
Poorly written or vague policies may have cost state-run Medicaid services $1 billion in payments over nearly four years, a new state-commissioned report finds. ... The report said that neither amount necessarily implies fraud, waste or abuse.
Report: Poor policy language may have cost $1B across 14 Medicaid services in Minnesota, Minnesota Reformer, February 6, 2026. News reporting (secondary source).
Checked against the source October 11, 2026.
Other numbers in circulation
Each of these measures something different. They are not steps toward one total and are never added together.
Cite this figure
Everything needed to cite this number and check it against the original.
$1B: Payments needing closer review, per Optum (the state-hired reviewer)
At-risk estimate
The 14 high-risk Medicaid service types, $9.4 billion in claims reviewed. January 2022 through October 2025 (46 months of claims).
Report: Poor policy language may have cost $1B across 14 Medicaid services in Minnesota (Minnesota Reformer). News reporting; secondary source.
February 6, 2026
October 11, 2026
$1B: Payments needing closer review, per Optum (the state-hired reviewer). Type: At-risk estimate. Covers: January 2022 through October 2025 (46 months of claims). Source (secondary): Minnesota Reformer, “Report: Poor policy language may have cost $1B across 14 Medicaid services in Minnesota,” February 6, 2026, https://minnesotareformer.com/2026/02/06/report-poor-policy-language-may-have-cost-minnesota-1-7b-across-14-medicaid-services/ Via MN Public Tools, mnpublictools.com/fraud/figure/optum-1b-at-risk (checked October 11, 2026).
Every figure in one file: spreadsheet (CSV) · JSON.
Changes to this record
Dates, amounts, titles, and wording corrected across the section after a full review
People charged but not convicted are presumed innocent, and amounts labeled alleged come from charging documents, not proven losses. Method and corrections