{"id":474603,"date":"2026-02-17T22:02:17","date_gmt":"2026-02-17T22:02:17","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/474603\/"},"modified":"2026-02-17T22:02:17","modified_gmt":"2026-02-17T22:02:17","slug":"maine-house-oversight-committee-grills-dhhs-over-improper-medicaid-payments","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/474603\/","title":{"rendered":"Maine House Oversight Committee grills DHHS over improper Medicaid payments"},"content":{"rendered":"

PORTLAND (WGME) \u2013 The investigation into Maine\u2019s Medicaid program continues after a multi-state audit found millions in improper or potentially improper payments for autism services.<\/p>\n

\u201cTo question the credibility of civil servants is not appropriate,\u201d DHHS Commissioner Sara Gagne-Holmes said. \u201cWe are not the ones doing the improper billing.\u201d<\/p>\n

\u201cBut you’re not providing any oversight either, commissioner,\u201d Rep. Chad Perkins (R-District 31) said.<\/p>\n

\u201cI beg to differ,\u201d Gagne-Holmes said.<\/p>\n

There was a heated exchange inside the State House Friday between Oversight Committee members and DHHS.<\/p>\n

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.<\/p>\n

\u201cHow does this slip through the cracks? These are big numbers,\u201d Rep. Michael Lemelin (R-District-53) said<\/p>\n

\"The<\/p>\n

The investigation into Maine\u2019s Medicaid program continues after a multi-state audit found millions in improper or potentially improper payments for autism services. (WGME)<\/p>\n

\u201cWe don’t know what our providers\u2019 records look like until we look at them,\u201d Office of MaineCare Services Associate Director of Compliance Bill Logan said.<\/p>\n

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.<\/p>\n

While that is going on, the state agency is working on a corrective action plan due by March 5.<\/p>\n

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.<\/p>\n

\u201cIf 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,\u201d Gagne-Holmes said.<\/p>\n

Meanwhile, Republican leaders continue to hold their ground, claiming the providers are committing widespread fraud.<\/p>\n

\u201cThe only thing we can hope is that the federal government comes in, finds these fraudsters and holds them accountable,\u201d House Minority Leader Billy Bob Faulkingham (R-Winter Harbor) said.<\/p>\n

\"The<\/p>\n

The investigation into Maine\u2019s Medicaid program continues after a multi-state audit found millions in improper or potentially improper payments for autism services. (WGME)<\/p>\n

But DHHS has rejected that claim, saying the report identified potential documentation and compliance issues, and no examples of fraud.<\/p>\n

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\u2019s Office for a review of potential wrongdoing.<\/p>\n","protected":false},"excerpt":{"rendered":"PORTLAND (WGME) \u2013 The investigation into Maine\u2019s Medicaid program continues after a multi-state audit found millions in improper…\n","protected":false},"author":2,"featured_media":474604,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253],"class_list":["post-474603","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-health","tag-health-care","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/474603","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=474603"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/474603\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/474604"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=474603"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=474603"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=474603"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}