Maine Suspends Medicaid Payments After Federal Fraud Findings

The administration of Janet Mills suspended payments to five Medicaid and Medicare service providers suspected of fraud and referred one provider to law enforcement. These actions follow a period of tension between state officials and the federal government over the management of MaineCare. In June 2026, the state also terminated two providers over health and safety risks and dis-enrolled 28 caregivers.

These state actions coincided with findings from the Centers for Medicare and Medicaid Services. Administrator Mehmet Oz stated during a Department of Justice press conference in Philadelphia that a federal review showed 90 percent of billed and paid home care services for adults with autism in Maine lacked justifiable backup. Oz attributed the rise in such fraudulent schemes to the COVID-19 pandemic, suggesting criminals believed the government would not follow up on funds distributed during that era.

State officials disputed the 90 percent figure and criticized Oz for prioritizing meetings with conservative media and political candidates over state administrators. However, the federal government had previously issued a conditional recertification to Maine's Medicaid Fraud Control Unit due to inadequate staffing levels. This follows a January audit by the Office of Inspector General for the Department of Health and Human Services that identified nearly $47 million in improper payments for autism services. Maine Senate Republican Leader Trey Stewart credited the Trump administration for forcing the state to crack down on suspect payments.