Two powerful members of Congress sent a sharply worded letter to Minnesota Human Services Commissioner Lucinda Jesson, KSTP reports. They want Jesson to answer some pointed questions about Minnesota's $4 billion Medicaid program. Sen. Charles Grassley, R-Iowa, and Rep. Darrell Issa, R-California, fear the state has improperly received roughly $500 million in federal Medicaid reimbursements in the past decade. Jesson has said an independent auditor will look into it.

Republicans in the U.S. House and Senate have asked for more information from Minnesota about its Medicaid program. State Human Services Commissioner Lucinda Jesson already traveled to Capitol Hill to testify in person as Congress looks into possible overpayments. The insurance program for low-income Minnesotans is run jointly by the state and federal governments.

The Dayton administration is asking the federal government to approve changes to Minnesota's Medicaid program that could save the state $151 million over five years, the Pioneer Press reports. Some of the savings would come through a proposal that asks the federal government to pay for state costs in mental health care, which the feds may not go for, one observer says.

Congress is seeking more information and documents from state officials into whether four HMOs artificially inflated Medicaid costs to illegally receive federal matching dollars.

The number of Minnesotans on Medicaid shot up at nearly twice the national rate over the past two years, while state costs soared by 40 percent to surpass $4 billion for the first time. There now are about 733,000 Minnesotans in the state-federal health insurance program for the poor -- called Medical Assistance in Minnesota -- an increase of 125,000 in two years, according to a new federal study.

Add the Centers for Medicare and Medicaid Services to the list of federal agencies investigating the Medicaid program in Minnesota. The agency that runs the federal government's two key health insurance programs wants answers to questions about how Minnesota sets payment rates for managed care organizations in the state's Medicaid program.

Federal officials are already looking into Minnesota's handling of its Medicaid program. Now the state will join them. The human services commissioner says an outside auditor will look into questions about whether Minnesota overpaid HMOs, which could have allowed the state to receive more than its share of federal reimbursement.

Minnesota is the first state to gain federal approval of a new system of paying hospitals and clinics that treat Medicaid patients. Officials say the system will reward providers that keep patients healthier and cut costs. When hospitals succeed in saving the taxpayer-funded program money, some of the savings will be shared with the hospitals.