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Maine Morning Star

4 stories

Maine Suspends Medicaid Payments to Five Providers on Fraud Allegations

Maine announced payment suspensions for five Medicaid providers based on fraud allegations, including Portland-based Gateway Community Services. The action follows months of Republican criticism that the Mills administration had inadequately addressed Medicaid fraud. The suspensions represent credible allegations of fraud triggering payment holds under federal Medicaid program integrity requirements. Maine did not disclose the specific nature of the fraud allegations or the total payment amounts suspended.

mainemorningstar.com

Legal·ME·14d ago

Maine Supreme Court Upholds $750M Medicaid Transport Contract with Modivcare

The Maine Supreme Court ruled Tuesday in favor of the state's 10-year, $750 million Medicaid non-emergency transportation contract with Denver-based Modivcare, ending a legal challenge by nonprofit provider Penquis. The decision allows Maine DHHS to proceed with the statewide contract, consolidating NEMT services under a single vendor. The ruling resolves a multi-year procurement dispute and establishes the operational framework for Medicaid transportation services statewide. The contract represents one of the largest NEMT procurements nationally and affects transportation access for Maine's Medicaid beneficiaries.

mainemorningstar.com

Federal Policy·ME·16d ago

Medicaid Cuts in HR 1 Expected to Drop 31,000 Maine Enrollees, Strain Rural Hospitals

The "One Big Beautiful Bill Act" (HR 1), enacted in July 2025, imposed substantial Medicaid funding reductions and new administrative requirements. In Maine, approximately 31,000 enrollees are projected to lose coverage due to these administrative burdens. Those losing coverage are expected to shift to charity care at hospitals. The changes threaten financial stability for rural hospitals and local economies dependent on Medicaid reimbursement.

mainemorningstar.com

State Policy·ME·57d ago

Maine GOP Group Petitions DHHS for Stricter MaineCare Anti-Fraud Rules

Lead Maine, a Republican-led advocacy group, submitted over 3,500 signatures petitioning the Maine Department of Health and Human Services to adopt new anti-fraud rules for the state's MaineCare program. The group, led by State Rep. Laurel Libby, argues the proposed changes would strengthen oversight of MaineCare providers and taxpayer spending. The petition seeks mandatory rulemaking to establish additional fraud prevention and program integrity requirements. If the petition meets statutory requirements, DHHS would be required to initiate a formal rulemaking process, including public comment periods and potential implementation timelines.

mainemorningstar.com