Real oversight for $1.4 billion in taxpayer funds.
The Problem
MaineCare consumes roughly one-quarter of the entire state budget: $1.4 billion every year. When oversight fails at this scale, Mainers pay twice, as taxpayers funding the program, and as patients when dollars meant for care disappear into improper billing and weak controls.
Federal auditors have documented tens of millions in improper payments. State program integrity capacity is tiny relative to the volume. Providers are paid first and questioned later.
Two Targeted Rule Changes
Require On-Site Inspections
Any provider billing MaineCare must be verified in person before enrolling in the program and can be inspected without warning during any fraud or billing investigation. No phone calls or emails as a substitute.
Crack Down on Payment Fraud
Strengthen the state’s ability to audit and recover improper payments to providers who are billing MaineCare for services that were never delivered. Better tools to pause payments during active investigations.
Read the Full Proposed Rule Changes
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