CMS launches audit of Maine’s Medicaid program

The U.S. Centers for Medicare and Medicaid Services (CMS) has launched a program integrity audit of Maine’s Medicaid program, known as MaineCare. The federal agency stated the audit will examine oversight operations and processes in high-risk areas, specifically assessing safeguards against fraud, waste, and abuse.

The audit will evaluate how the state identifies risks, refers suspected fraud, and manages improper payments. No specific details regarding which programs are being audited will be released while the investigation is ongoing.

This federal scrutiny follows an earlier audit by the U.S. Department of Health and Human Services Office of Inspector General, which found that Maine had made at least $45.6 million in improper payments related to support services for autistic children in 2023. In that instance, officials noted the findings did not include accusations of fraud.

A spokesperson for the Maine Department of Health and Human Services stated that protecting MaineCare from abuse is essential for ensuring healthcare availability and responsible taxpayer investment. The state maintains its own program integrity unit to monitor the program.