Maine Republicans Demand Immediate Action Over Alleged $1 Million Medicaid Fraud at Gateway Community Services

By Jim Thomas | Thursday, January 01, 2026 04:35 PM EST

Maine Republicans have renewed calls for accountability after the state suspended all MaineCare payments to Gateway Community Services following health officials’ credible fraud allegations. The suspension comes as lawmakers assert taxpayers deserve transparency regarding potential billing abuses.

An audit found Gateway billed MaineCare for services that may not have been provided or were ineligible for coverage, prompting state health officials to halt Medicaid payments to the Portland-based nonprofit last week.

Republican lawmakers highlighted vulnerabilities in MaineCare oversight during a Tuesday news conference. Assistant House Minority Leader Katrina Smith, R-Palermo, stated residents have “had enough” and raised serious questions about accountability. Smith alleged Gateway Community Services received state funds for services it did not provide, claiming the organization is “defrauding us because they are personally gaining wealth from our tax dollars without doing the work they claim to do.”

The audit indicated potential overpayments exceeding $1 million for claims Gateway submitted between March 2021 and December 2022. House Minority Leader Billy Bob Faulkingham, R-Winter Harbor, emphasized that fraud investigations must precede any consideration of additional supplemental budgets. “We want answers. And as we’re going into another supplemental budget, we want this fraud addressed, and we want some fiscal responsibility,” he said.

Republicans also cited estimates that more than 5,000 organizations bill the MaineCare program while only 22 state employees investigate fraud claims.

The Maine Department of Health and Human Services confirmed it has referred its audit to the Office of the Maine Attorney General for further review, with a spokesperson stating the department will “continue to hold providers to the highest standards and ensure accountability in the use of public funds.” Gateway Community Services denied the allegations, noting complaints stem from a “disgruntled employee” and that billing, documentation, and compliance protocols are sound.

In a press release, the organization added Republican lawmakers have treated the allegations as fact rather than allegations while confirming ongoing cooperation with oversight agencies.

Democratic legislative leaders responded by emphasizing their commitment to investigating waste, fraud, and abuse while cautioning against assumptions about causes. Senate President Mattie Daughtry, D-Brunswick, and House Speaker Ryan Fecteau, D-Biddeford, stressed investigations must be grounded in evidence and due process.