The nation’s top Medicaid official has a message for Maine: the jig is up.
CMS Administrator Dr. Mehmet Oz issued a pointed statement to The Maine Wire this week in response to reports that Paradise Residential Services LLC had become the latest multi-million dollar MaineCare scandal to unfold under the Mills Administration.
“The allegations coming out of Maine are deeply disturbing and underscore exactly what we’ve been warning about — bad actors are exploiting gaps in oversight to game the Medicaid system,” Oz said. “When providers bill inflated rates while failing to deliver basic standards of care, it’s not just fraud, it’s a betrayal of vulnerable patients and families who depend on these services.”
Oz’s comments came in response to an inquiry from The Robinson Report about the Maine Department of Health and Human Service’s decision to de-authorize Paradise Residential Services, LLC, a MaineCare provider that has billed taxpayers more than $16 million over the last five years.
According to Medicaid records, the Portland-area autism residential care company charged more than twice the national rate for identical services. Former employees have described a culture of neglect, billing manipulation, and insider self-dealing.
“There will be no more gaming the system — CMS is committed to rooting out fraud, protecting patients, and restoring integrity to these critical programs,” said Oz.
DHHS declined to comment on the story, citing pending litigation with Paradise.
Paradise declined a phone interview.
The Oz latest salvo lands after months of increasingly untenable denials from Augusta.
In late February, The Maine Wire revealed exclusively that Mills had quietly asked federal officials for extra time to comply with a Feb. 6 demand from CMS to respond to Medicaid fraud questions.
That request was rejected.
Mills responded by attacking the messenger. She ripped Oz publicly as a “TV Doctor,” accused the Trump administration of weaponizing the fraud investigation for political purposes, and put out a statement defending her oversight of the MaineCare program.
On March 7, her office said it had submitted a “detailed response” to the CMS inquiry.
The Trump administration, through the Vance-led anti-fraud task force and Oz’s CMS, has made Maine a test case.
Oz’s statement this week makes the federal posture plain. Maine’s Medicaid administrators may have spent months telling Washington nothing to see here.
Washington is no longer accepting that answer.
Gaps in oversight
That’s intentional
The Feds are on the way North on 95 and they’re loaded for bear.
The Mills administration should be ashamed allowing this fruad to go unchecked!
I wonder what the humble “OYSTER FARMER” has to say about this?
Time for the Feds to dig deep,…. say 8 years deep,…..
It means nothing if there are no prison sentences. And I doubt we get the money back. Crime does pay
DHHS Was corrupt and morally bankrupt 40 years ago when it was DHS, it’s no better now, and it’s elder services division particularly needs investigating.
What I find disturbing is how quickly DHHS social workers are ready to staple an “autism“ label onto someone with no medical or other basis for doing so. I suspect the fraud extends into people who are in legitimate autism treatment, but don’t belong there.
Remember, this is the fraud they got the mental health Institutes, e.g. BMHI, shut down 50 years ago. A lot of people who are not mentally ill got locked up, and an outrage society shut the whole system down in response, which is why we have no mental healthcare today for those who actually need it.
I fear that something similar will happen to autism if we don’t reign in DHHS. Saying that everyone has autism essentially it’s saying that no one has autism and will lead to no one receiving care for it. Hopefully Dr. Oz will look at random diagnosi for autism and see the extent to which there any medical basis for them.
The crime here starts in DHHS.
As to a certain oyster farmer, I don’t know how many people realize that he’s not just getting almost $60,000 a year in free money from the taxpayers, but that is tax free. Period throw in some of the other incidentals and he’s getting the equivalent of $90,000 a year for being mentally ill.
Yes, PTSD is a mental illness.
And while someone with PTSD, could conceivably have success working on an oyster farm on a quiet back cove somewhere, how could someone who truly does have PSD survive in DC let alone as the United States Senator?
I don’t know how many people have ever been down to Washington DC, but it is a big and noisy city, far worse than even Boston. People who really have combat related PTSD can’t deal with that city, how does he plan to?
If, in fact, he still genuinely has PTSD. And the untold scandal in Maine, far worse than this fraud that’s coming out, are the people who may have been disabled 10, 20, 30, even 40 years ago, maybe we’re totally disabled then, but definitely aren’t now! There are DHHS social workers, who go out “totally disabled” in their 20s and proceed to collect more money than the average Mainer EARNS — for life — and wind up with nice houses and nice cars, etc.
Grrrr…..
Well when you tell the POTUS “see you in court” guess you targeted all of Maine Janet. In this case it is good, now the Fraud will all be uncovered.
the jig is up