MaineCare under federal review following fraud and improper payment findings

By Rep. Chad Perkins, R-Dover-Foxcroft

I’m State Rep. Chad Perkins of Dover-Foxcroft with the Weekly Republican Address.

For months now, a troubling pattern has been coming to light in MaineCare — a pattern of fraud, waste and abuse involving millions of taxpayer dollars.

This issue has continued to grow unchecked and recently, the federal government issued a serious warning to the State of Maine.

In a letter to state officials, the Centers for Medicare and Medicaid Services wrote, “Maine’s fact pattern shares alarming similarity to patterns elsewhere in the U.S. where CMS and law enforcement have observed rapid program cost growth, minimal documentation standards, and coordinated schemes across providers.”

CMS has given Maine 30 days to explain how fraud is being tracked and prevented and warned that federal action could follow if the response is inadequate. This warning didn’t come out of nowhere.

We’ve already seen multiple cases come to light. There is a credible allegation of fraud involving Gateway Community Services, with more than $1 million billed for services not rendered. Then there is the Bright Future Healthier You case, where payments were made to an entity that had no clients and delivered no services. And now there is a federal audit by the Office of the Inspector General at DHHS identifying over $45 million in improper MaineCare payments related to autism services, with the state asked to repay more than $28 million.

Following the federal warning, these concerns were the focus of a recent legislative briefing. During that meeting, I pushed back on attempts to minimize the problem and chalk it up to simple “paperwork errors.”

“When they consistently bill for things they know they can’t bill for, that’s not a paperwork error — that’s fraud.”

 I can’t make this any more simple, MaineCare serves hundreds of thousands of Mainers, and most providers are honest and follow the rules. The people who rely on these services deserve a system that works. But when oversight is weak or non-existent, when improper payments go undetected, it invites even more fraudsters to set up shop in Maine to steal from program beneficiaries and taxpayers.

When millions are lost, the entire program is threatened — and it forces taxpayers to pick up the bill. And because many of these fraudulent providers are likely to have little in the way of assets for the state to recover, the taxpayers will likely be on the hook to repay federal tax dollars out of their pockets. In effect, Maine taxpayers will be paying the bill twice.

Legislative Republicans are, once again, pushing for answers, transparency and stronger safeguards. Protecting MaineCare means protecting both the people who rely on it and the taxpayers who fund it. This administration was warned of this problem years ago and Republicans have been warning of this problem and calling on Democrats to act for years.

And now, the problem of waste, fraud and abuse has grown to the point where it can no longer be covered up or explained away.

It is time for the Mills Administration to own up to its oversight failures, cooperate with the federal government and take immediate corrective action to avoid a catastrophic loss of federal funds and a severe budget shortfall. The recipients of these vital services deserve that, the taxpayers in Maine deserve that.

This has been Rep. Chad Perkins with the Weekly Republican Radio Address. Thank you for listening, subscribing, sharing and following us on Facebook, X, TikTok and Instagram.

And as always, may God bless you and your families and the Great State of Maine.

Perkins is currently serving his second term in the Maine House representing District 31, which includes the towns of Brownville, Dover-Foxcroft, Lake View Plantation, Medford, Milo, the Orneville Township, Southeast Piscataquis and the Atkinson Township. He serves on the 132nd Legislature’s Joint Standing Committee on Criminal Justice and Public Safety. He also serves as the Lead Republican on the Government Oversight Committee.

Perkins is a consultant and former law enforcement officer. He served in the United States Army for 11 years, specializing in armor, intel and aviation.  He serves his community as a member of the American Legion, North American Versatile Hunting Dog Association, Gun Owners of America, American Radio Relay League, Sportsman’s Alliance of Maine, Project Appleseed and Gun Owners of Maine.

Perkins and his wife Dolly have 11 children.