The U.S. Centers for Medicare and Medicaid Services has launched a program integrity audit of Maine\u2019s Medicaid program, federal officials confirmed.<\/p>\n
The agency said in a statement Friday that the audit will examine MaineCare\u2019s \u201coversight operations and processes in high-risk areas.\u201d<\/p>\n
\u201cThe audit will assess the state\u2019s safeguards against fraud, waste, and abuse, including how it identifies risks, refers suspected fraud, and addresses improper payments,\u201d according to the agency\u2019s statement.<\/p>\n
CMS oversees the Medicaid program, which is operated by the states with federal oversight. Medicaid programs, which include insurance and healthcare services for lower-income people, are funded with a blend of federal and state dollars.<\/p>\n
The statement offered that no further details, including what specific programs the agency is auditing, will be available while the audit is ongoing.<\/p>\n
Maine was in the crosshairs of federal regulators earlier this year, when a U.S. Department of Health and Human Services Office of Inspector General audit found the state had made at least $45.6 million in improper payments<\/a>. The audit, which examined support services for autistic children in 2023, said Maine failed to document services correctly and did not complete \u201cpost-payment reviews.\u201d<\/p>\n At the time, Maine officials responded by noting that the Office of Inspector General\u2019s audit did not include accusations of fraud.<\/p>\n In response to CMS announcing that the agency is conducting an audit, Lindsay Hammes, a Maine Department of Health and Human Services spokesperson, said in a statement on Friday that \u201cprotecting MaineCare from fraud and abuse is essential to making sure that health care remains available for the people and families who rely on it and that taxpayer dollars are invested responsibly.\u201d <\/p>\n Hammes said the state DHHS has its own program integrity unit to monitor MaineCare programs for fraud. When needed, the Office of the Maine Attorney General will investigate potential crimes, she said.<\/p>\n