Audit: Changing procedures may safeguard $1 billion in MN Medicaid programs

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A third-party audit assessing Minnesota Medicaid programs at high risk for fraud found the state could safeguard $1 billion in the next four years by changing its policies on payment reviews. But the changes that could result in those savings for now remain hidden from public view.

Minnesota’s Department of Human Services on Friday released an initial report on fraud vulnerabilities in 14 programs it considers high risk. It reviewed more than $9.4 billion in payments between January 2022 and October 2025. Portions of the report regarding vulnerabilities are redacted.

Gov. Tim Walz in October ordered an audit and a 90-day payment pause for the programs as scrutiny continued to build on fraud in federally-funded programs run by his administration. The pause would help the state detect “suspicious billing activity and scrutinize the use of public funds,” the governor’s office said at the time.

However, the audit released Friday focused more on procedure for fraud prevention than finding actual fraud. The independent report from health care company Optum leaves questions unanswered for the public.

Redactions in report

Sections of the report released to the media on weaknesses in Medicaid programs and recommendations for fixing them are covered with large black bars and boxes, citing Minnesota law protecting “trade secret information.”

Minnesota Medicaid Director John Connolly said the redactions were made in accordance with state law to protect information on vulnerabilities from people who might use it to exploit the state.

“We don’t want to share information with bad actors, with fraudsters that will tip them off to how we’re looking at fraud and looking at risk or vulnerability to fraud,” he told reporters during a Friday media briefing. “We’re trying to balance transparency and provide as much up-to-date information as transparently as we can with you all and with the public, but also protect information that could present more risk.”

Connolly said some of the changes Optum recommended could require action by the Legislature, and that the state Department of Human Services would share more information with lawmakers during the upcoming session, which starts Feb. 17.

‘First phase’

State officials described the report as the “first phase” of developing a payment review process for the high-risk programs.

Those include Housing Stabilization Services, which it shut down last fall as federal prosecutors filed charges in a multimillion-dollar fraud scheme, and autism support services, which have also seen schemes now facing federal prosecution.

In autism programs alone, the audit flagged 90% of claims in the past four years “that didn’t match clear policies and procedures,” according to Human Services officials. The suspicious claims don’t necessarily indicate waste, fraud or abuse, according to the report, which Connolly said was not a “forensic investigation of program integrity.”

“We may need to clarify policies so claims that deserve to be approved are not unnecessarily flagged, and providers may not have the training they need to file claims properly,” Connolly said.

“Optum was looking at, perhaps filling trends that might have raised some questions, things that may not have seemed clinically appropriate,”  he later explained. “And did that, of course, by looking not only at their own frameworks and analytics, but looking at our own policies in our provider manual.”

Payment policy

Optum estimated the state could have avoided $1 billion in fraud risk over a four-year period by making “refinements ” to the payment policy. More than $700 million of that was in autism service programs, where federal investigators have uncovered fraud schemes, though again, the report noted those savings don’t necessarily imply there was fraud.

Optum also found that in the same period, the state could have directly recovered more than $52 million from instances where providers of Medicaid-funded services clearly violated state policies.

Human Services will continue to work with Optum over the next nine months to develop a “pre-payment strategy” for Medicaid programs, according to agency officials.

The three-month mark report accomplished a few things, DHS officials said. It established an analytics process before payments, did 192 target analytics across the 14 high-risk programs and started a pre-claim analysis process in each payment cycle.

Programs deemed high risk by Minnesota include: Early Intensive Developmental and Behavioral Intervention Services for Autism; Integrated Community Supports; Nonemergency Medical Transportation; Peer Recovery Services; Adult Rehabilitative Mental Health Services; Adult Day Services; Personal Care Assistance/Community First Services and Supports; Recuperative Care; Individualized Home Supports; Adult Companion Services; Night Supervision; Assertive Community Treatment; Intensive Residential Treatment Services; and Housing Stabilization Services.

One of the 14 programs, Housing Stabilization Services, is no longer operating. Human Services ended the program in October after learning of a federal investigation into allegations of significant fraud.

What else is happening with fraud issue?

On Monday, Human Services announced a new push to scrutinize providers in state-run Medicaid programs at high risk for fraud, including a significant expansion of unannounced site visits.

The plan to significantly expand on-site validations comes as federal officials threaten to cut off Medicaid funding amid accusations of significant, widespread fraud in programs administered by the agency.

The state is currently appealing a January decision by the administration of President Donald Trump to withhold more than $2 billion in Medicaid funding from the 14 high-risk programs. Funding remains in place as the appeals process continues.

Human Services is making a call out to Minnesota’s tens of thousands of state employees seeking individuals to fill 168 temporary positions to visit providers in all 87 counties. There are currently only six dedicated site visit staff.

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Ex-MLB player Yasiel Puig found guilty of obstruction and lying to federal officials

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By JAIMIE DING

LOS ANGELES (AP) — A jury has found former major league outfielder Yasiel Puig guilty of obstruction of justice and lying to federal officials investigating an illegal gambling operation, the U.S. Attorney’s Office said Friday.

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The verdict came after a multiweek trial that featured testimony from Major League Baseball officials and Donny Kadokawa, a Hawaii baseball coach that Puig placed bets through. Puig now faces up to 20 years in federal prison.

Puig initially pled guilty to a felony charge of lying to federal agents investigating an illegal gambling operation. He acknowledged in an August 2022 plea agreement that he wracked up more than $280,000 in losses over a few months in 2019 while wagering on tennis, football and basketball games through a third party who worked for an illegal gambling operation run by Wayne Nix, a former minor league baseball player.

Nix pled guilty in 2022 to conspiracy to operate an illegal gambling business and subscribing to a false tax return. He is still awaiting sentencing.

Authorities said Puig placed at least 900 bets through Nix-controlled betting websites and through a man who worked for Nix.

Prosecutors said that during a January 2022 interview with federal investigators, he denied knowing about the nature of his bets, who he was betting with, and the circumstances of paying his gambling debts.

But he changed his tune months later, announcing that he was switching his plea to not guilty because of “significant new evidence,” according to a statement from his attorneys in Los Angeles.

“I want to clear my name,” Puig said in the statement. “I never should have agreed to plead guilty to a crime I did not commit.”

The government argued that he intentionally misled the federal investigators. They played in court audio clips of Puig speaking English and brought expert witnesses to testify on Puig’s cognitive abilities, the New York Times reported.

His attorneys said that Puig, who has a third-grade education, had untreated mental-health issues and did not have his own interpreter or criminal legal counsel with him during the interview with federal investigators where he purportedly lied.

Puig’s former attorney Steven Gebelin testified that during the January 2022 interview, Puig tried to be helpful in answering the investigators’ questions and the interpreter struggled with Puig’s Spanish language dialect, according to the New York Times.

Puig batted .277 with 132 home runs and 415 RBIs while appearing in seven major league seasons, the first six with the Dodgers, where he earned an All-Star selection in 2014.

Dodgers broadcaster Vin Scully called Puig the “wild horse” for his on-field antics and talent at a young age, joining MLB at 22, a year after escaping his home country of Cuba.

He played for the Cincinnati Reds and the Cleveland Indians in 2019 before becoming a free agent. He then played in the Mexican League and last year he signed a one-year, $1 million contact with South Korea’s Kiwoom Heroes.

Body believed to be Lil Jon’s son is found dead in pond near Atlanta

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MILTON, Ga. (AP) — A person believed to be the son of rapper Lil Jon has been found dead in a pond north of Atlanta, police said Friday.

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Nathan Smith, known professionally as D.J. Young Slade, left his home in Milton “under unusual circumstances” early Tuesday morning, police said.

Lil Jon said in a statement posted to his Instagram page that he and Smith’s mother, Nicole Smith, are “extremely heartbroken for the tragic loss of our son.”

“Nathan was the kindest human being you would ever meet,” the statement reads. “He was immensely caring, thoughtful, polite, passionate, and warmhearted — he loved his family and the friends in his life to the fullest.”

Nathan Smith, 27, “ran out of his house and has been missing since,” police said in a missing person poster they circulated on social media.

He “left on foot and does not possess a phone,” police said. “He may be disoriented and in need of assistance. Family and friends are concerned for his safety.”

Milton police immediately began searching for Smith, police said. After being unable to locate him, police and other agencies expanded the search include a pond near Smith’s residence. Shortly before noon Friday, Cherokee County Fire Department divers found a body in the pond.

“The individual is believed to be Nathan Smith, pending official confirmation by the Fulton County Medical Examiner’s Office,” police said in a statement. The medical examiner did not immediately respond to inquiries about the case on Friday.

“Based on the investigation to date, there is no indication of foul play,” police said. “However, the Milton Police Department Criminal Investigations Division will continue to treat this as an open and active investigation.”

Police said no further details would be released until the cause and manner of death are determined by the medical examiner.

Milton is a suburban town about 30 miles north of Atlanta.

Lil Jon, born Jonathan Smith, is an Atlanta rapper and producer who was a central figure in the crunk subgenre of hip-hop. He’s known for songs including 2002’s “Get Low” with his group the East Side Boyz and 2013’s “Turn Down For What” with DJ Snake.

He also has a daughter, Nahara, who was born in 2024.

Musk’s underground tunnels in Las Vegas face scrutiny over safety, environmental concerns

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By JESSICA HILL

LAS VEGAS (AP) — Elon Musk’s “Vegas Loop,” a network of underground tunnels to ferry passengers in Teslas, was under fresh scrutiny this week from Nevada lawmakers who raised concern about alleged workplace safety and environmental violations.

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Lawmakers spent hours grilling state safety officials over alleged violations by the Boring Company, the Musk-owned venture with tunneling projects also planned in Nashville and Dubai. Company officials declined to attend but provided written answers defending the project.

“I think they are a company that acts like they are kind of above the law and want to play by their own set of rules,” Democratic Assemblymember Howard Watts, whose district includes the tunnel project, told The Associated Press.

First opened in 2021, the Vegas Loop offers free rides around the Las Vegas Convention Center and charges between $4 and $12 for rides to some hotels, casinos and the airport. The Teslas can be hailed by website or accessed at stations. The Boring Company is approved to build 68 miles of tunnels and 104 stations over the next few years in Vegas, a city that lacks fast and robust public transit.

Vegas Mayor Shelley Berkley praised the project in January after the city issued a permit for a new tunnel.

“The city is excited to bring an innovative transportation option to downtown Las Vegas and create another way for visitors to experience all that the city has to offer,” she said.

Fines levied against the company

The Boring Company has been accused of breaking multiple safety and environmental rules. Between 2020 and 2026, 17 complaints were filed with the Nevada State Occupational Safety and Health Administration. Last year ProPublica reported the company was accused of nearly 800 environmental violations for its Las Vegas project.

Construction is underway near the Vegas Loop on Wednesday, Feb. 4, 2026, in Las Vegas. (AP Photo/Ty ONeil)

Of those 17 complaints, one resulted in an inspection with eight proposed citations, including claims that 15 to 20 employees were injured after getting burned with accelerants and that there were no showers available for employees who got sprayed with the accelerants. Several other complaints are still open. The Boring Company has paid nearly $600,000 in fines, most of which went to the local water reclamation district for discharging untreated wastewater. The company is fighting around $355,000 in fines with Nevada’s OSHA and the Nevada Division of Environmental Protection.

The company did not return emails seeking comment from The Associated Press. But in a letter to lawmakers, the company emphasized its safety procedures, including daily inspections and workplace safety training.

Watts on Tuesday also highlighted a September 2025 incident in which a worker suffered a crushing injury inside a tunnel after being pinned between two 4,000-foot pipes. Firefighters used a crane to extract him from the tunnel opening, Watts said.

In a September statement to local news outlets, the company said it was investigating the incident and that the safety and well-being of its employees are top priority. It added that the employee was in stable condition and doing well.

Watts said lawmakers may bring forward legislation when they return to session next year to speed up the process for assessing violations and shorten the timeline for contesting them.

A sign directs motorists into the Vegas Loop on Wednesday, Feb. 4, 2026, in Las Vegas. (AP Photo/Ty ONeil)

The scrutiny in Nevada comes as Musk’s company has started construction in Nashville on the Music City Loop despite opposition from some Nashville officials concerned about safety, transparency and a lack of local input. The initial 13-mile stretch of tunnels will connect the city’s airport and downtown.

Fines withdrawn

Last year, the state withdrew over $425,000 of fines stemming from a May 2025 incident in which two firefighters received chemical burns while on the site for a training exercise.

The reports from OSHA had mistakes and anomalies, meaning they likely wouldn’t be able to meet the high burden of proof required to justify the fines, Salli Ortiz, the agency’s legal counsel, told lawmakers. The state learned the two firefighters had opted to not wear a second layer of protective clothing, and The Boring Company conducted six safety meetings with the fire department in advance of the drill, according to inspection reports.

Democratic lawmakers criticized Republican Gov. Joe Lombardo and his administration for going soft on the company.

“The idea that there is external pressure that is swaying my decision making, or our division’s decision making, or that there’s any pressure that comes from me as a result of pressure from on high is incorrect,” Kris Sanchez, director of the state Department of Business and Industry, told lawmakers Tuesday.

A Tesla is driven into the Vegas Loop under the city on Wednesday, Feb. 4, 2026, in Las Vegas. (AP Photo/Ty ONeil)

Easy transport for conventiongoers

The tunnel system is already a hit with many visitors, especially during conventions like the annual Consumer Electronics Show in January. On a recent weekday, a stop at the Las Vegas Convention Center had a steady stream of Teslas picking up and dropping off people.

San Diego resident Devin Newcomb, a frequent visitor, said the Vegas Loop helps him get around the city, and it will only help more when it is extended to places like the Venetian.

Teslas are lined up inside the Vegas Loop Wednesday, Feb. 4, 2026, in Las Vegas. (AP Photo/Ty ONeil)

“It’s awesome. I love it,” he said.

Florida resident Samantha Mingola has been using Vegas Loop while attending an expo at the convention center. She said it is easier to set up than other rideshares, and it has been convenient because she is staying at a hotel with a loop station.

Still, she said she worries the tunnels could cave in and is unsure about a company run by Musk.

“It’s a good idea but it scares me,” Mingola said on her way to the station.