Maine Medicare Scandal Sends a National Message
Segment #769
📌 A. Gateway Community Services — Central Controversy
1. State Audits, Payment Suspensions, & Fraud Allegations
Gateway Community Services — a Portland and Lewiston nonprofit that contracts with MaineCare to deliver services (including interpreter services) — has become the focal point of fraud scrutiny:
Maine Department of Health and Human Services (DHHS) suspended MaineCare payments to Gateway after a third state audit found overbilling of more than $1 million for March 2021–Dec 2022, primarily for interpreter services and other services not properly documented or covered. DHHS terms this a credible allegation of fraud, which automatically triggers a referral to the Maine Attorney General’s Office for investigation.
This is the third audit. Earlier audits found overpayments of about $660,000 from 2015–2018 and other billing issues; the 2024 audit is still under appeal.
State audits reviewed 15,000 claims, including billing for interpreter services where the documentation didn’t show interpreters were needed or present, or services were delivered by non-qualified staff.
Important: Overbilling in audits is not the same as proven criminal fraud. Suspension for suspected fraud means DHHS believes there is credible evidence worth referring to prosecutors — but no criminal indictment of Gateway or its executives has been publicly disclosed at this time.
2. Whistleblower Allegations
Taxpayers in Maine have been bilked out of millions of dollars from the state's Medicaid program, according to a whistleblower who in an interview with NewsNation likened the case to a burgeoning scandal in Minnesota, where people in the Somali community are accused of defrauding taxpayers of $1 billion meant for social services
Conservative outlets have amplified claims from former Gateway employees:
Christopher Bernardini, a former program coordinator, alleged in May 2025 that Gateway fabricated records and billed for services not provided, including manipulating electronic tracking and timesheets.
He claims MaineCare overpaid Gateway close to $29 million from 2019–2024 and that fraudulent practices intensified during the COVID-19 era with increased PPP funds flowing.
These allegations have appeared in The Maine Wire and national conservative outlets like Breitbart, though they have not been independently verified by prosecutors and Gateway denies them.
đź“Ś B. Political Dimensions & Republican Lawmaker Actions
Conservative politicians in Maine and at the federal level have engaged heavily with this issue:
1. State Republican Response
Maine Republicans have repeatedly pressed for broader investigations and accountability:
Senate Republican members requested that the Legislature’s watchdog (OPEGA) investigate whether DHHS audits are sufficient and whether other MaineCare vendors may have similar issues.
House Minority Leader Billy Bob Faulkingham and other GOP leaders have publicly criticized the Mills administration for what they describe as ignoring or downplaying fraud, and have asserted that the state’s own audits were not acted upon quickly enough.
State Rep. Deqa Dhalac (D-South Portland), a former Gateway assistant executive director, has been targeted by Republicans for removal from the legislature’s budget committee because of her past employment, though she states she had no involvement in billing practices.
GOP lawmakers also held news conferences highlighting that they believe Gateway is only the “tip of the iceberg” of MaineCare fraud, signaling political concern that the problem may extend beyond a single provider.
2. Federal Republican Involvement
U.S. Rep. James Comer (R-KY), Chair of the House Oversight Committee, wrote to the U.S. Treasury requesting Suspicious Activity Reports related to Gateway, tying the Maine case to broader welfare fraud investigations (including ones that have featured prominently in Minnesota).
Federal agents — specifically from Homeland Security Investigations — reportedly visited Gateway’s offices amid ongoing inquiries tied to these suspicious activity reports and broader oversight committee interest.
This federal involvement has intensified the political dimension beyond Maine’s borders.
đź“Ś C. Governor Janet Mills and State Executive Involvement
1. State Administration’s Role
Gov. Janet Mills’ administration (Democrat) oversaw the DHHS responses to audit findings, including the payment suspensions to Gateway.
The DHHS audits span periods under both Mills and the previous Republican governor Paul LePage, underscoring that overbilling findings predate the current administration.
2. Political Pushback Toward Mills
Republican lawmakers and conservative commentators have accused Gov. Mills and Democratic leadership of being slow or insufficiently transparent about the Gateway audits and broader potential fraud. They allege this reflects a broader mismanagement or lax oversight of welfare programs.
Some critics frame the lack of a swift criminal prosecution as political reluctance, though legal processes typically protect confidentiality until formal charges are filed.
State officials and Mills allies counter that due process must be followed, that auditing and legal standards are rigorous, and that allegations should not be conflated with proven wrongdoing.
đź“Ś D. Media & Ideological Amplification
Conservative Outlets
Breitbart, The Maine Wire, and other conservative outlets have emphasized the Gateway audits as evidence of significant Medicaid fraud and have repeatedly highlighted alleged improper billing, alleged misuse of funds, and political connections as part of a broader narrative of welfare abuse.
These sources also highlight Republican criticisms of Democrat policymakers for not acting sooner.
Mainstream Reporting
Local outlets like Maine Public and the Bangor Daily News focus on the audit findings and the procedural aspects of payment suspension and investigations, noting that audits do not automatically equate to proven fraud.
Gateway has issued statements denying allegations and noting that audits often reflect billing errors or documentation issues rather than intentional fraud.
đź“Ś E. Summary of Investigations & Political Implications
AspectStatus / NotesSourcesGateway overbilling findingsMultiple audits show over $1M in alleged overbilling; payments suspended & AG referral made; no criminal charge public yetWhistleblower claimsAllegations of forged records and systemic billing abuse (not legally confirmed)Maine Republican actionsLegislative calls for investigations, oversight requests, committee pressureFederal Republican involvementRep. Comer’s House Oversight interest, Suspicious Activity RequestsGovernor’s roleState administration oversaw audit responses; critics say action was slowMedia framingConservative media emphasize fraud narrative; mainstream media emphasize audit vs. proven fraud distinction
đź“Ś Key Takeaways
Audits show substantial MaineCare overpayments to Gateway, with billing issues serious enough for DHHS to suspend payments and refer the case as suspected fraud.
No criminal indictments have yet been publicly announced against Gateway or its leadership; investigations appear ongoing.
Maine Republican lawmakers have been vocal, calling for deeper investigations, federal oversight action, and political accountability.
Gov. Mills and her administration are criticized by Republicans for their handling of the issue, though defenders emphasize due process and proper auditing practices.
Conservative sources amplify narratives tying the case to broader welfare fraud concerns, while mainstream outlets focus on audit findings and procedural developments.