State regulators heard testimony Thursday on proposals to require in-person inspections of some MaineCare providers and to cut off payments to agencies suspected of improper billing.
In June, the conservative political group Lead Maine submitted thousands of petition signatures to force rulemaking at the Maine Department of Health and Human Services. The group is pushing the issue at a time when DHHS is facing scrutiny from the Trump administration over management of the state’s Medicaid program, known as MaineCare.
Lead Maine wants DHHS to conduct in-person and on-site inspections of MaineCare provider businesses or service locations. The proposed rules would make it clear that a phone call or a “desk review” would not be sufficient. A second proposed rule would require DHHS to suspend payments to providers while the department reviews potential improper billing.
“When DHHS has identified improper billing, Maine taxpayers should not bear all of the financial risk while the department sorts it out,” said state Rep. Laurel Libby, a Republican from Auburn and Lead Maine’s executive director. “You have to plug the hole in the boat before you start bailing it out.”
The vast majority of the roughly 20 people who spoke during Thursday’s public hearing supported the proposals. But several MaineCare providers raised concerns about how they would be implemented, even though they supported the overall goal of reducing fraud and waste.
Bev Uhlenhake, representing the Maine Association of Personal Care Agencies, testified that fraud and waste take money away from those who need care. But Uhlenhake said the proposal would seem to allow inspectors into the homes or private spaces of MaineCare clients who are receiving services. She also said that suspending all payments during a potentially lengthy billing review process could force some agencies to halt all care.
“In many cases, the agencies — particularly those who provide MaineCare — operate on very thin margins because the reimbursements are supposed to equal that which they are spending. If payments stop, services stop. And that hurts older Mainers and Mainers with disabilities.”
Republican lawmakers have repeatedly accused the Mills administration of failing to adequately root out waste and potential fraud in MaineCare. And top Trump administration officials — including Vice President JD Vance and Mehmet Oz, the director of the Centers for Medicare and Medicaid Services — have alleged that Maine’s program is rife with fraud, although they have yet to provide evidence of widespread issues.
The issue has become a top Republican talking point headed into the 2026 elections.
A recent federal audit also identified roughly $46 million in potentially improper payments for MaineCare services to children with autism. But those improper payments did not necessarily represent fraud and the state has agreed to repay the federal government about half of the sum.
The Mills administration has also defended its efforts to address waste and fraud within MaineCare and other welfare programs. Last month, DHHS announced that it had suspended payments to five providers based on credible allegations of fraud and terminated payments to two others, citing credible allegations of health and safety risks.
DHHS is accepting comments on the proposed rules through Sept. 20.
This story appears through a media partnership with Maine Public.