Minnesota's New Medical Assistance Fraud Law Takes Effect August 1, 2026

What changes on August 1, 2026

Minnesota enacted the new statute in May 2026 as part of 2026 Minnesota Laws, chapter 127, article 7, section 3. The law creates a standalone medical assistance fraud section with its own prohibited acts, penalty levels, records offense, limitations language, venue provisions, and restitution rules.

The effective-date language is specific: section 609.467 takes effect August 1, 2026, and applies to crimes committed on or after that date. The date matters because the new section defines the offense and structures potential punishment.

What conduct the new statute covers

The new law reaches schemes intended to obtain medical assistance money through false pretenses, representations, promises, or concealed material facts. It also addresses claims, reimbursement requests, cost reports, and rate applications when a person acts with intent to defraud and knows or has reason to know that part is ineligible for payment.

Other provisions address false or omitted information in provider enrollment materials; ownership, operation, management, or control involving a person barred from enrolling as a provider; false or altered service records; certain claims for personal care assistance or community first services and supports when required conditions were not met; and intentional destruction of required records after a lawful request from a state or law enforcement agency.

The mental-state language is not identical across all eight categories. Some provisions require an intent to defraud, while others use "knowingly," "intentionally," or "knowing or having reason to know." A charge identifies an allegation; it does not by itself establish that any of those elements can be proved.

How the penalty levels work

The general statutory maximum is ten years in prison, a $20,000 fine, or both. If a violation causes aggregate loss to any victim of more than $100,000 but not more than $1,000,000, the statute authorizes up to 20 years in prison, a fine of up to $100,000, or both. If the aggregate loss is more than $1,000,000, the statute authorizes up to 30 years in prison, a fine of up to $1,000,000, or both.

These are maximum penalties authorized by the statute, not a prediction of the sentence in any case. The applicable allegation, amount of claimed loss, criminal history, sentencing law, and other case-specific facts can affect what issues must be addressed.

The statute also creates a separate gross-misdemeanor records offense. It applies when a person submits a listed claim, payment request, cost report, or rate application and then knowingly and intentionally fails to maintain medical, health care, and financial records required under the referenced medical-assistance laws or rules.

The law also addresses timing, venue, and restitution

Section 609.467 treats violations as continuing offenses for statute-of-limitations purposes. It says a violation extends to acts committed during the course of the alleged scheme, conspiracy, or conduct, and it links timeliness to whether part of that continuing conduct occurred within the applicable limitations period.

The statute permits prosecution in a county where any part of the offense occurred or where the entity receiving the claim, reimbursement request, cost report, or rate application is located. It also authorizes restitution for losses resulting from the crime and, under stated conditions, for similar related conduct that was not charged.

For restitution tied to similar related conduct, the law includes procedural limits: the conduct must be within the applicable limitations period, the prosecutor must give notice at least five business days before sentencing, the defendant may challenge restitution, and the prosecution bears the burden under a preponderance-of-the-evidence standard.

Why the records and the exact allegation matter

Medical assistance cases can involve claims data, service records, enrollment documents, ownership disclosures, training and supervision records, and communications among several people or entities. The new statute separates distinct kinds of alleged conduct, so the precise subdivision and theory charged matter.

Questions may include who prepared or submitted a record, what information was available at the time, whether a required condition was actually unmet, what a person knew or intended, how the claimed loss was calculated, and where the alleged conduct occurred. For general information about document-heavy investigations and intent issues, visit Keil Defense's white-collar and fraud defense resource.