PORTLAND (WGME) – The investigation into Maine’s Medicaid program continues after a multi-state audit found millions in improper or potentially improper payments for autism services.
“To question the credibility of civil servants is not appropriate,” DHHS Commissioner Sara Gagne-Holmes said. “We are not the ones doing the improper billing.”
“But you’re not providing any oversight either, commissioner,” Rep. Chad Perkins (R-District 31) said.
“I beg to differ,” Gagne-Holmes said.
There was a heated exchange inside the State House Friday between Oversight Committee members and DHHS.
They met for the first time last week following a U.S. Inspector General report, which noted the DHHS Medicaid program made at least $45.6 million in improper fee for service Medicaid payments for autism services in Maine.
“How does this slip through the cracks? These are big numbers,” Rep. Michael Lemelin (R-District-53) said
The investigation into Maine’s Medicaid program continues after a multi-state audit found millions in improper or potentially improper payments for autism services. (WGME)
“We don’t know what our providers’ records look like until we look at them,” Office of MaineCare Services Associate Director of Compliance Bill Logan said.
DHHS says it’s now going through each of the 31 provider records the OIG investigated to either agree, partially agree or reject the findings.
While that is going on, the state agency is working on a corrective action plan due by March 5.
Leaders say it’ll include the actions the department will take based on the OIG’s recommendations, which include refunding the federal government more than $28 million.
“If we find there are mistakes, we are going to collect that money, we are going to repay the federal government and will have the state share as well,” Gagne-Holmes said.
Meanwhile, Republican leaders continue to hold their ground, claiming the providers are committing widespread fraud.
“The only thing we can hope is that the federal government comes in, finds these fraudsters and holds them accountable,” House Minority Leader Billy Bob Faulkingham (R-Winter Harbor) said.
The investigation into Maine’s Medicaid program continues after a multi-state audit found millions in improper or potentially improper payments for autism services. (WGME)
But DHHS has rejected that claim, saying the report identified potential documentation and compliance issues, and no examples of fraud.
DHHS says it conducts audits every year from a small sample of the 4,000 providers they oversee. Each year, only four or five of those cases are then forwarded to the Attorney General’s Office for a review of potential wrongdoing.