Somali-American Refugee's Medicaid Agency Submitted Bogus MaineCare Claims for Years, Former Employees Allege
A former billing manager has submitted allegations to Maine's Office of the State Auditor alleging Gateway Community Services engaged in systemic fraudulent billing for at least seven years.
Former employees of Gateway Community Services, a migrant-run social services agency with offices throughout Maine, have alleged in interviews with The Robinson Report that the company artificially inflated Medicaid billing for at least five years.
The whistleblower allegations surfaced after a report by the Maine Wire on March 21 revealed that Gateway Community Services had previously been audited by the Maine Department of Human Services (DHHS).
That audit resulted in a Notice of Violation stating the company had over-billed MaineCare, Maine's version of Medicaid, by close to one million dollars from 2015-2017. As of at least 2022, that sum had not been repaid, according to state records, and there’s never been a public explanation as to why.
Despite the unpaid debt, the Gateway Community Services was allowed to continue billing MaineCare for a total of $28.8 million from 2019 to 2024, according to DHHS records. In addition, the company has received multiple other contracts from the …
