Two days after Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz visited Maine to meet with former Governor Paul LePage and Jon Fetherston of The Maine Wire to discuss alleged fraud in the state’s Medicaid-funded home care system, the Mills administration announced it had suspended payments to five MaineCare providers, terminated additional providers, and taken enforcement action against dozens of agencies.
The timing is notable.
On Wednesday, the Maine Department of Health and Human Services (DHHS) released a summary of enforcement actions taken during June, revealing that the department suspended MaineCare payments to five providers based on what it described as “credible allegations of fraud.”
The department also announced it carried out two emergency provider terminations over serious health and safety concerns and disenrolled 28 agencies that failed to submit a single MaineCare claim within one year of enrollment.
The announcement came less than 24 hours after Oz publicly criticized Maine’s Medicaid system during a federal press conference in Philadelphia, where he singled out the state’s autism and home care programs as examples of what federal officials say is widespread abuse of taxpayer dollars.
“The massive increases that have grown, to the kinds of numbers you could not imagine being able to show on a clipboard with 90% of services billed and paid for in Maine in particular, where there is no justifiable backup for nine out of ten services, you can’t justify they should have happened. It’s the opposite of what you normally expect,” Oz said.
Federal Audit Put Maine Under National Scrutiny
Federal concerns over MaineCare spending did not begin this week.
In January, the U.S. Department of Health and Human Services Office of Inspector General released an audit finding that approximately $45.6 million to $46 million in MaineCare payments for Section 28 children’s autism and rehabilitative services were improperly claimed or lacked required documentation.
The report raised serious questions about oversight of one of MaineCare’s fastest-growing programs.
Just weeks earlier, in December 2025, Maine DHHS suspended MaineCare payments to Gateway Community Services LLC after alleging more than $1.1 million in improper billing and potential fraud.
Wednesday’s announcement suggests Gateway was far from an isolated case.
Beyond the five payment suspensions, DHHS said it also took licensing enforcement action against 15 Personal Care Agencies, including issuing conditional licenses, refusing new licenses, assessing financial penalties against 12 agencies, voiding incomplete license applications, and referring one provider to law enforcement.
The department also declined to renew the licenses of two mental health agencies.
DHHS has not publicly identified the five providers whose payments were suspended, citing administrative confidentiality.
Oz Meets with The Maine Wire
Before speaking at Tuesday’s federal press conference, Oz traveled to Maine, where he met with former Governor Paul LePage and Jon Fetherston of The Maine Wire to discuss mounting concerns over fraud within Maine’s Medicaid-funded home care and autism services system.
During the visit, Oz pointed to the dramatic growth in Maine’s home-based autism and intellectual disability programs since LePage left office, describing a six-fold increase in spending while federal auditors continue identifying significant documentation failures.
The Maine visit preceded Oz’s public comments in Philadelphia, where he used Maine as a national example while calling for greater accountability over Medicaid spending.
Mills Administration Pushes Back
Governor Janet Mills’ administration has rejected the characterization that Maine is failing to police fraud.
A spokesperson criticized Oz’s decision to meet with LePage and The Maine Wire, rather than state health officials, arguing the visit demonstrated the federal effort was “more interested in politics than fighting fraud.”
The administration has also defended its oversight efforts by pointing to the suspension of Gateway Community Services, the June payment suspensions, emergency provider terminations, licensing enforcement actions, and ongoing investigations as evidence that the state has been actively monitoring providers and pursuing enforcement when warranted.
Governor Has Declined Repeated Requests for Comment
For months, The Maine Wire has sought interviews with Governor Janet Mills regarding allegations of fraud within MaineCare’s autism and home care programs, the findings of federal audits, and growing concerns over oversight of taxpayer-funded services.
Governor Mills has declined or failed to respond to at least six requests from this reporter seeking comment on the issue.
Instead, the administration has largely relied on written statements from DHHS officials while resisting direct questions about the expanding federal scrutiny.
Wednesday’s announcement represents one of the broadest public disclosures yet of enforcement activity inside MaineCare, coming as federal investigators continue examining billions of dollars in Medicaid spending and after senior Trump administration officials made clear that Maine remains a priority.
For months, critics have argued that the state has downplayed concerns about fraud while federal investigators uncovered mounting evidence of improper payments. Whether Wednesday’s announcement reflects an ongoing enforcement effort or a response to growing federal pressure, it marks another significant development in the widening scrutiny of Maine’s Medicaid system.
