More than $52.3M
Claims the Optum review identified as unambiguous violations of stated policy, flagged for recovery. Not criminal findings.
Who reported it, and what it covers
reported January 30, 2026
46 months of fee-for-service paid claims. The report’s stated range (October 2022 to December 2025) does not match 46 months, so the exact window is uncertain
The 14 high-risk Medicaid service types, fee-for-service claims only (managed-care claims were outside the review)
A review’s estimate of payments vulnerable to or needing review for problems. Explicitly not proven fraud.
What it does not show
Not a criminal finding. These are claims Optum flagged as violating stated payment policy, which the state can seek to recoup.
What the source says
Identify over $52.3 million in direct recoveries attributable to clearly defined policy violations across the 14 high-risk service areas from paid claim analyses.
Minnesota Payment Integrity: Phase 1 Summary Report (Final, January 30, 2026), Optum, for Minnesota DHS, January 30, 2026. State agency data (primary 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.
more than $52.3M: Payments that clearly violated policy, per Optum’s review
At-risk estimate
The 14 high-risk Medicaid service types, fee-for-service claims only (managed-care claims were outside the review). 46 months of fee-for-service paid claims. The report’s stated range (October 2022 to December 2025) does not match 46 months, so the exact window is uncertain.
Minnesota Payment Integrity: Phase 1 Summary Report (Final, January 30, 2026) (Optum State Government Solutions, for Minnesota DHS (redacted copy held by the Legislative Reference Library)). State agency data; primary source.
January 30, 2026
October 11, 2026
more than $52.3M: Payments that clearly violated policy, per Optum’s review. Type: At-risk estimate. Covers: 46 months of fee-for-service paid claims. The report’s stated range (October 2022 to December 2025) does not match 46 months, so the exact window is uncertain. Source (primary): Optum, for Minnesota DHS, “Minnesota Payment Integrity: Phase 1 Summary Report (Final, January 30, 2026),” January 30, 2026, https://www.lrl.mn.gov/docs/2026/other/260346/mn-pi-phase-1-summary-report-13026-final-redacted.pdf Via MN Public Tools, mnpublictools.com/fraud/figure/optum-52m-violations (checked October 11, 2026).
Every figure in one file: spreadsheet (CSV) · JSON.
Changes to this record
The $9 billion estimate now quotes its cited source, and the Optum and CMS figures match their sources
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
Written by Dan Swenson, an attorney who serves on the Nowthen City Council, in his personal capacity. It is not an official publication of the City of Nowthen or any other government.