Maine’s Department of Health and Human Services has suspended MaineCare payments to Gateway Community Services after a newly completed state audit found the Portland-based nonprofit overbilled the Medicaid program by more than $1 million, sharply escalating a years-long controversy now drawing state, federal, and political scrutiny.
According to DHHS, the payment suspension was imposed because of suspected fraud, a designation that automatically triggers a referral to the Office of Attorney General for potential investigation. The attorney general’s office declined to confirm whether it is actively investigating the company.
The audit, which had not previously been publicly disclosed, is the third conducted by the state into Gateway’s MaineCare billing practices. Two earlier audits, completed in 2018 and 2024, found the company overbilled the program by more than $660,000. The latest audit, initiated in 2023, identified what DHHS described as “serious” billing irregularities, including billing for interpreter services and other services not covered by MaineCare, as well as failures to properly document services provided.
While Medicaid overbilling is technically distinct from fraud and is often appealed, DHHS has previously said suspending provider payments is reserved for cases involving credible fraud concerns.
The notice of violation and payment suspension were dated Tuesday. Gateway has the right to appeal the suspension.
Reporter Turned Away at Gateway Offices
On Tuesday, this reporter visited Gateway Community Services’ offices in both Portland and Lewiston seeking comment. Staff members at both locations said they could not comment on the situation.
Gateway has previously denied allegations made by a former employee who claimed the organization falsified billing records, saying instead that it has worked with the state to reconcile overbilling uncovered during prior audits.
Until now, DHHS had largely avoided alleging wrongdoing, previously characterizing recoupments exceeding $100,000 as merely “higher than normal.” Each of the three recoupments sought from Gateway far exceeds that threshold, making the decision to suspend payments a significant escalation by the Mills administration.
Federal Oversight and Political Pressure
The scandal has now reached Washington. Congressman James Comer (R, Kentucky) has called for a formal investigation into Gateway Community Services through the U.S. House Committee on Oversight and Government Reform, which has asked the U.S. Treasury to produce any Suspicious Activity Reports connected to Gateway officers.
The Maine Wire reached out to Maine State Deqa Dhalac (D) Tuesday to the phone number she has listed on her Maine State Legislature website page, that number is disconnected. The Maine Wire also reached out multiple times today via text and phone to Rep Yusf Yusf (D) , as well. Those messages were not returned. Both State Reps. have long ties with GateWay Communities.
The request is part of a broader congressional investigation tied to a massive nonprofit Medicaid fraud scheme in Minnesota.
Federal prosecutors in Minnesota have described that case as “staggering industrial-scale fraud” worth billions of dollars. Conservative activists have attempted to link Gateway to that broader pattern of abuse, though the alleged overbilling in Maine represents a much smaller amount.
Governor Silent as Timing Raises Questions
The Maine Wire has been requesting comment from Gov. Mills (D) for more than two weeks regarding the Gateway scandal but has received no response. The timing of DHHS’s announcement, which came days before Christmas and just ahead of Mills’ decision to close state offices on Christmas Eve due to a snowstorm is open to criticism for its timing.
Would Governor Mills taken any action if Rep. Comer and the OverSight Committee had not brought national attention to the controversy? It’s not a good optic for Mills who is running for U.S. Senate. One that will will certainly draw a comment from
President Trump. The Maine Wire reached out the White House Press Office for a comment.
According to DHHS, Gateway’s first audit covered 2015 through 2018 during the administration of former Gov. Paul LePage and was completed in 2018. The second audit concluded in 2024 under Mills. The third audit, initiated in 2023 in response to internal data analytics rather than a complaint, examined billing from March 2021 through December 2022.
Bigger Oversight Questions
Medicaid serves more than 83 million Americans nationwide and is administered by states with federal oversight. In Maine, program integrity and fraud prevention are overseen by DHHS.
As Gateway weighs an appeal and congressional investigators demand financial records, the case is likely to intensify debate over MaineCare oversight, nonprofit accountability, and why it took years and millions of dollars in questionable billing, before the state finally moved to cut off payments.
