Maine Republicans renewed calls for accountability after the state suspended all MaineCare payments to Gateway Community Services following what health officials called a credible fraud allegation, saying taxpayers deserve answers about possible billing abuses.
An audit found Gateway billed MaineCare for services that may not have been provided or were ineligible for coverage, prompting state health officials to halt Medicaid payments to the Portland-based nonprofit last week.
Republican lawmakers said at a Tuesday news conference that the suspension exposes weaknesses in MaineCare oversight and that taxpayers deserve transparency in how public health dollars are spent.
Assistant House Minority Leader Katrina Smith, R-Palermo, recently remarked that state residents have "had enough" and that the allegations raise serious questions about accountability.
"The people of Maine are demanding accountability for the money they send to Augusta every single day," she said.
Smith alleged Gateway Community Services received state money for services it did not provide.
"They are defrauding us because they are personally gaining wealth from our tax dollars without doing the work they claim to do," she said.
Smith and other GOP leaders said audits show potential MaineCare overpayments of more than $1 million for claims Gateway submitted between March 2021 and December 2022.
House Minority Leader Billy Bob Faulkingham, R-Winter Harbor, said the issue should 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 wider probe of MaineCare billing, citing estimates that more than 5,000 organizations bill the program while only 22 state employees investigate fraud claims.
The Maine Department of Health and Human Services confirmed that it has referred its audit of Gateway to the Office of the Maine Attorney General for further review, and a spokesperson said the department 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 of fraud.
In a press release earlier this month, the organization said the claims stem from complaints by a "disgruntled employee" and maintained that its billing, documentation, and compliance protocols are sound.
A Gateway spokesperson also said Republican lawmakers have treated the allegations as fact rather than allegations and that the organization continues to cooperate with oversight agencies.
Democratic legislative leaders responded to the GOP pressure by saying they take allegations of waste, fraud, and abuse seriously while cautioning against assumptions about the underlying causes of the claims.
Senate President Mattie Daughtry, D-Brunswick, and House Speaker Ryan Fecteau, D-Biddeford, said investigations must be grounded in evidence and due process.
Jim Thomas ✉
Jim Thomas is a writer based in Indiana. He holds a bachelor's degree in Political Science, a law degree from U.I.C. Law School, and has practiced law for more than 20 years.
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