Last month, the Minnesota Attorney General’s office filed charges in Ramsey County District Court against four individuals in relation to an alleged fraud scheme that occurred between 2018 and 2020. A small number of state employees misused their access to the Minnesota Eligibility Technology System (METS) to direct payments from the State of Minnesota to navigator organizations managed or owned by relatives of the state employees in question. 

MNsure’s system of internal controls uncovered the alleged fraud. When state employees discovered irregularities, they voiced their concerns to management and immediate action was taken to minimize the impact and prevent the alleged fraud from escalating.

DHS and MNsure have fully cooperated with the law enforcement investigation and implemented new internal controls to reduce risks. Now that the investigation has concluded, pursuant to Minnesota Statutes (section 13.055), we are notifying the households that were affected by the data privacy breach that occurred when staff inappropriately accessed their data. It is important to note that although employees misused their access to state technology systems, their actions did not affect consumers’ eligibility determinations nor enrollment in health insurance coverage. In addition, there was no evidence that indicates there was an intent to acquire consumer information, or that information was shared outside of DHS and MNsure. If a consumer reaches out to you regarding their notice, please refer them to their notice for information on whom to contact.

While this is disappointing news for our organization, our consumers, and our assister community, it does not define us. And it is an important reminder that it is everyone’s responsibility to protect the data privacy of Minnesotans and to prevent waste, fraud and abuse of state resources.

If you have any concerns about any form of fraud, waste, abuse or ethical violations, we want to know. You can file a report or complaint by emailing mnsurecompliancehotline@mnsure.org or by calling the MNsure anonymous complaints telephone line at 1-844-466-7873. More information is also available in /help/fraud/index.jspGet Help.