Maine Republicans have renewed calls for accountability following the state’s suspension of all MaineCare payments to Gateway Community Services after health officials identified credible fraud allegations. The decision, made last week, comes after an audit revealed that Gateway billed MaineCare for services that may not have been provided or were ineligible for coverage.
At a Tuesday news conference, Republican lawmakers highlighted weaknesses in MaineCare oversight and emphasized that taxpayers deserve transparency regarding how public health funds are spent. Assistant House Minority Leader Katrina Smith, R-Palermo, stated that residents have “had enough” and the allegations raise serious questions about accountability.
“The people of Maine are demanding accountability for the money they send to Augusta every single day,” Smith said. She further alleged that Gateway Community Services received state funds for services it did not provide, adding, “They are defrauding us because they are personally gaining wealth from our tax dollars without doing the work they claim to do.”
Smith and other GOP leaders reported audits showing potential overpayments exceeding $1 million for claims Gateway submitted between March 2021 and December 2022. House Minority Leader Billy Bob Faulkingham, R-Winter Harbor, stressed that the issue must be addressed before lawmakers consider additional supplemental budgets.
“We want answers. And as we’re going into another supplemental budget, we want this fraud addressed, and we want some fiscal responsibility,” he said.
Republicans also called for a broader investigation of MaineCare billing practices, noting that over 5,000 organizations bill the program while only 22 state employees handle fraud claims.
The Maine Department of Health and Human Services confirmed it has referred its audit to the Office of the Maine Attorney General for further review. A department spokesperson stated the agency will “continue to hold providers to the highest standards and ensure accountability in the use of public funds.”
Gateway Community Services has denied the allegations, stating the claims stem from complaints by a “disgruntled employee” and that its billing, documentation, and compliance protocols are sound. The organization also noted Republican lawmakers have treated the allegations as fact rather than allegations.
Democratic legislative leaders responded to GOP pressure by affirming their commitment to investigating waste, fraud, and abuse while cautioning against assumptions about the underlying causes. Senate President Mattie Daughtry, D-Brunswick, and House Speaker Ryan Fecteau, D-Biddeford, said investigations must be grounded in evidence and due process.
