The Maine Department of Health and Human Services (DHHS) sent a letter to the lawyer representing Gateway Community Services last week affirming “credible allegations of fraud” against the non-profit reported on extensively by The Maine Wire.
The DHHS provided a letter to the Portland Press Herald dated May 12 from William Logan, associate director of compliance for the Office of MaineCare Services, to Drummond Woodsum attorney Maureen Sturtevant representing Gateway.
The letter informed Gateway that the state has decided to uphold the December decision to suspend their MaineCare payments amid fraud allegations.
Logan reportedly wrote that the letter came in response to an informal request by Gateway for a review of their suspension.
The state suspended Gateway’s payments after state auditors found that the non-profit, operated by Abdullahi Ali and with strong ties to Rep. Dequ Dhalac (D-South Portland), overbilled Medicaid by $1.1 million for a variety of services from March 2021 through December 2022.
Previous audits found that Gateway overbilled by $663,000 from 2015 to 2018.
The DHHS has now officially confirmed in the letter that they believe there are credible reasons to believe the overbilling was a result of fraud, vindicating The Maine Wire’s reporting.
Sturtevant responded to a request for comment from the Portland Paper denying allegations of fraud.
“Gateway Community Services declines to comment at this time, other than that it stands by its denial of the allegations of fraud,” she reportedly said.
Logan’s letter addressed claims from Gateway that attempted to cast doubt on the credibility of informants, pointing out that auditors reviewed documents submitted by Gateway itself and those maintained by government agencies.
“Those records established a foundational basis that warrants further investigation of the potential fraud,” he reportedly said.
He further explained that the DHHS is conducting an investigation to determine whether Gateway should be permanently barred from receiving MaineCare payments.
Gateway has 60 days to appeal the DHHS ruling, and Sturtevant reportedly told the Portland paper that they will be reviewing the decision and considering their options within that time frame.
It does seem that they have used their 60 days for something. A source close to the nonprofit told The Maine Wire on Thursday that Gateway deactivated its employee emails and deleted employee documents, though The Maine Wire cannot independently verify those claims.
The DHHS provided the Portland paper with the May 12 letter well after it was initially sent, and the paper released its report on Wednesday.
The Maine Wire reached out to DHHS press secretary Lindsay Hammes, requesting a copy of the letter, but she did not respond.
The DHHS letter affirming The Maine Wire’s reporting comes as Maine’s massive healthcare fraud industry has faced increased federal scrutiny, including from Vice President JD Vance, who visited Maine two days after the letter was sent to discuss fraud in the state.
The current Maine government will protect Gateway and all the others. Too much money changes hands to EVER prosecute