Gov. Janet Mills listens at a roundtable about ICE activity in Maine with Gov. Janet Mills and several Maine mayors as well as State House representatives and the Attorney General at Portland City Hall on Wednesday, January 28, 2026. (Brianna Soukup/Staff Photographer)
Gov. Janet Mills said she expects President Donald Trump’s administration to withhold Medicaid funding from Maine even after state officials responded Friday to the federal government’s request for information on MaineCare by describing how the program operates within the law and properly investigates claims of fraud.
Maine Department of Health and Human Services Commissioner Sara Gagne-Holmes sent responses Friday to Dr. Mehmet Oz, the Centers for Medicare and Medicaid Services administrator, which answered 33 questions Oz had sent the state in early February.
The questions came after a January report from a federal watchdog that outlined $45 million in potential improper payments for autism support services in MaineCare, which serves roughly 400,000 residents.
Oz had attempted to link Maine to ongoing fraud investigations in Minnesota, where the Trump administration has paused nearly $260 million in Medicaid payments. It is also targeting other Democratic-led states such as New York with similar probes.
Mills had said last month the state would respond to Oz, but also argued Trump used unfounded fraud claims as a “pretense” for ramped-up Immigration and Customs Enforcement operations that hit both Maine and Minnesota.
Gagne-Holmes and the Mills administration responded Friday to meet a 30-day deadline to provide the Trump administration with information on a wide-ranging list of questions regarding MaineCare. After providing a detailed list of answers that got into technical matters, Gagne-Holmes concluded her more than 40-page response by saying Maine “has implemented — and continues to refine — a coordinated set of safeguards aimed at preventing, detecting and addressing improper payments.”
“We operate MaineCare in accordance with federal and state requirements,” Gagne-Holmes wrote. “As always, we welcome guidance and technical assistance from CMS as a partner in promoting the best interests of MaineCare members and ensuring appropriate use of public funds.”
Gagne-Holmes reiterated that the federal inspector general’s January report on potential improper autism support payments did not include “findings or allegations of fraud.”
The federal report flagged that rehabilitative and support payments for children with autism grew from $52.2 million in 2019 to $80.6 million in 2023, but Gagne-Holmes noted the increase was an “intended and CMS-approved result” of rate-setting reforms Maine lawmakers have approved in recent years.
The state’s response explained how its Medicaid Fraud Control Unit had 22 cases referred to it from 2021 to 2025, with one case resulting in a guilty plea, 12 cases open and five cases dismissed.
A separate MaineCare Program Integrity Unit has issued 290 notices of violation to providers in response to hundreds more complaints it has received since 2021. The unit has identified more than $37.5 million in overpayments, according to the state’s response, which noted that final amounts could change pending appeals.
The state’s response repeatedly noted existing joint state and federal efforts to combat fraud. At one point, Gagne-Holmes outlined dozens of reasons why a provider could be kicked out of Maine’s Medicaid program. At another, she noted that certain types of providers, including autism support services providers, already receive heightened scrutiny from the state.
Mills also released a video Friday in which she reiterated that she feels the Trump administration’s judgement on the extent of fraud in Maine is predetermined —and that she expects the president “to retaliate against Maine in the same manner they have other states: by withholding federal Medicaid funding.”
A Centers for Medicare and Medicaid Services spokesperson did not immediately respond Friday evening to a request for comment on Mills and her administration’s response.
“Look, as district attorney, as your attorney general, and as your governor, I have always cracked down on fraud,” Mills said. “I’ve been going after criminals since before Dr. Oz was on TV peddling fake supplements to the American people.”
She added that “if the Trump administration attempts to halt Medicaid payments, the attorney general and I will not hesitate to see him in court to preserve critical access to health care for Maine people.”
Politics editor Kirby Wilson contributed to this report.