Minnesota's New Medical-Assistance-Fraud Tier: What Severity Level 8 Actually Means

Key Takeaways

• Minnesota added a new medical-assistance-fraud statute, Minn. Stat. section 609.467, effective for offenses on or after August 1, 2026.
• The over-$1-million tier is ranked at severity level 8 in the 2026 Sentencing Guidelines.
• At criminal-history score zero, that tier's presumptive sentence is 48 months, with a 41-to-57-month range.
• The statutory maximum for this tier is 30 years, a $1 million fine, or both — a ceiling, not an expected outcome.
• "Presumptive commitment" means the Guidelines recommend prison; it is not a mandatory minimum, and departures remain possible.

What Changed in Minnesota Law?

Minnesota restructured how it treats medical-assistance fraud. Under the prior approach, the conduct was generally charged as an attempted theft of public funds, which capped exposure regardless of how much was involved. The 2026 legislation replaced that with a dedicated offense, Minn. Stat. section 609.467, and built in tiers based on the aggregate loss amount (2026 Minn. Laws ch. 127, art. 7; the prior § 609.466 attempted-theft framing was repealed).

The practical effect: the alleged dollar amount now drives both the statutory penalty tier and, separately, where the offense lands on the Sentencing Guidelines grid. Those are two different mechanisms, and it helps to keep them apart.

What Is Severity Level 8?

Minnesota felonies are ranked by seriousness on a severity scale, and that ranking is one axis of the Sentencing Guidelines grid; criminal-history score is the other. The over-$1-million medical-assistance-fraud tier is ranked at severity level 8. At that level, even a person with no criminal history at all falls in the grid's presumptive-commitment zone.

At a criminal-history score of zero, severity level 8 carries a presumptive 48-month executed sentence, with a guideline range of 41 to 57 months where the court does not depart.

Does This Mean Mandatory Prison?

This is where headlines tend to overshoot. A "presumptive commitment" is not a statutory mandatory minimum. The distinction matters:

• A mandatory minimum is a floor the legislature sets by statute — the court generally cannot go below it.
• A presumptive commitment is the Guidelines' recommended disposition. The Guidelines are advisory, and a court may depart from the presumptive sentence when it identifies and articulates substantial and compelling circumstances for doing so.

So while the over-$1-million tier makes prison the presumptive outcome even at score zero, it does not eliminate the court's authority to depart in an appropriate case.

What Do the 30-Year and $1 Million Figures Mean?

The statute sets a maximum of 30 years in prison, a $1 million fine, or both, for this tier. A statutory maximum is a ceiling on what a court could impose — it is not the sentence the Guidelines call for, and it is not what a typical case at criminal-history score zero would produce. Confusing the statutory maximum with the expected sentence is a common way these situations get misread.

What Does the State Still Have to Prove?

None of this changes the burden of proof. The State must still prove, beyond a reasonable doubt, that the alleged conduct fits one of the specific forms of medical-assistance fraud the statute defines, and that the alleged loss actually supports the charged tier. The loss amount is not a formality — it is what moves a case between tiers and shifts the guideline calculation, so it is frequently contested. Criminal history and other guideline rules also factor into the final calculation.

What this means for you: If you are facing a medical-assistance-fraud allegation involving a large claimed loss, the charged tier and the alleged dollar figure deserve close scrutiny, and so does the difference between what the Guidelines presume and what the statute allows at the outer edge. These are fact-specific questions worth reviewing carefully with counsel.

Key Terms

• Severity level: A felony's seriousness ranking, one axis of the Sentencing Guidelines grid.
• Criminal-history score: The other grid axis, reflecting prior record.
• Presumptive commitment: The Guidelines' recommended disposition of prison for that grid cell.
• Departure: A sentence outside the presumptive range, allowed only on substantial and compelling circumstances.
• Statutory maximum: The legislative ceiling on a sentence — not the expected or presumptive outcome.