State of Maine Responds to CMS Medicaid Letter, Highlights Steps Taken under Mills Administration to Fight Fraud

Governor slams Trump Administration inquiry as a predetermined political cudgel to attack political opponents and dismantle Medicaid and vows to defend health care for Maine people

The State of Maine today issued its response to the February 6 letter and social media video from Dr. Mehmet Oz, the Administrator of the U.S. Centers for Medicare and Medicaid Services, requesting information about the management of Maine's Medicaid program. Today was the last business day before the requested response deadline.

In a video statement, Governor Janet Mills said the State "sent back a comprehensive response" that makes clear "the State of Maine is conducting oversight to ensure that MaineCare providers are held to high standards of care, that we have robust procedures and enforcement mechanisms to identify fraud, and that we take action in partnership with law enforcement to hold fraudsters accountable."

Read the State of Maine's full response letter to the Trump Administration (PDF).

Under Governor Mills, Maine has taken significant actions in recent years to increase oversight and scrutiny of Medicaid providers, including proposing legislation to require licensing standards on several providers for the first time ever. These standards include:

• Home and Community Support Services: In 2023, the Mills Administration proposed legislation to require licensure of all group homes in Maine delivering home and community support services. Prior to this, licensing for 1- and 2-bedroom homes was optional. The Legislature unanimously approved this bill, which was signed by the Governor in May 2023. The rules to implement the licensing went into effect on December 2, 2025, and existing agencies were required to submit license applications by January 15, 2026.
• Personal Care Agencies: In 2023, the Mills Administration proposed legislation to require licensure of all personal care agencies in Maine. Prior to this effort, these agencies were only required to register with the State. The Legislature unanimously approved this bill, which was signed by the Governor in June 2023. Licensing standards were put into place in August 2024.
• Behavioral Health: Under amended rules proposed by the Mills Administration in 2024, Home and Community Rehabilitative Support Services -- which include Applied Behavioral Analysis (ABA) providers, the subject of a recent Federal audit -- are subject to enhanced licensure requirements by the state to increase oversight, accountability, and ensure quality care.

With these standards in place, the Maine Department of Health and Human Services has the authority to exercise stronger oversight and enforcement powers over these providers, including requiring them to disclose client, employee, business, and financial records. These powers enable the Department to hold providers accountable to state regulations and ensure delivery of quality care.

But the Governor warned the facts do not matter to the Trump Administration.

"We have answered the Administration's questions -- but we know the substance and merit of those answers do not matter to them," said Governor Mills. "Under this President, addressing alleged fraud has become a political cudgel that he is using to desperately distract from his failing agenda. And let's be clear about who he is using that cudgel against: Democratic-led states, and people like me who dare to stand up to him."

The Governor continued by saying that the Trump Administration's inquiry is predetermined and warned that she expects the President "to retaliate against Maine in the same manner they have other states: by withholding Federal Medicaid funding."

"But make no mistake: if the Trump Administration attempts to halt Medicaid payments, the Attorney General and I will not hesitate to see him in court to preserve critical access to health care for Maine people," she said. "Maine is fighting fraud and we will continue to fight fraud. Our response makes that crystal clear. And Maine will not be intimidated by the threats of a President who is using allegations of fraud as a pretext to hurt people. We will fight back."

The State's response comes after the Mills Administration separately responded to an audit (PDF) from the Inspector General of the U.S. Department of Health and Human Services that alleged improper payments to providers of services to children with autism.

That audit -- a routine, programmatic action that is part of a broader ongoing Federal review of multiple states -- did not include findings or allegations of fraud. In recent years, Maine has increased investments to meet a rising need for services for children diagnosed with autism, in partnership with CMS.

"When it comes to services for children with autism -- services that CMS is now questioning -- we have increased spending to serve more kids. And in many cases, we took these actions because CMS had encouraged us to," the Governor said.

Maine maintains a robust, multi-layered program integrity framework designed to prevent improper payments, detect anomalous or suspicious activity, and ensure that suspected criminal conduct is promptly referred to appropriate state and federal law-enforcement authorities. When DHHS identifies a credible allegation of fraud in one of its programs, it refers the matter to the Office of Attorney General for investigation.

For more about information on how DHHS identifies and investigates allegations of fraud, waste and abuse, click HERE.