The Maine Department of Health and Human Services initiated a rulemaking process Wednesday that may lead to stricter oversight of the MaineCare program, which state and national Republicans have pushed for over several months.

Lead Maine, a group run by Rep. Laurel Libby (R-Auburn), submitted more than 3,500 signatures to initiate the rulemaking process in June. The two changes the organization is proposing would reinstate in-person inspections of MaineCare providers, which Libby said were commonplace before the pandemic, and require the state to place payments to providers suspected of improper billing into an interest-bearing escrow account until investigations are complete.

According to a notice posted by the health department Wednesday, the petition also proposes that the department require providers under payment suspension to continue offering care for medically necessary services to current MaineCare members.

Libby along with Republican gubernatorial nominee Bobby Charles spoke against fraud in the Medicaid system at a June press event announcing the petition. Since last December, when a Portland-based healthcare provider was put under payment suspension, state and national Republican lawmakers have claimed that the Medicaid program lacks oversight and is rife with fraud. The health department is not doing enough to combat misuse of public money while Democratic leaders are ignoring the issue, they claimed. 

In a statement announcing the start of the rulemaking process, Libby said, “Governor Mills and Augusta Democrats have abdicated their responsibility to provide adequate oversight of our MaineCare program.” 

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That rhetoric has been echoed by Vice President JD Vance and Mehmet Oz, administrator of the U.S. Centers of Medicare and Medicaid Services, who on separate visits to Maine expressed similar concerns. The Trump administration has also initiated crackdowns on alleged fraud in several Democrat-led states including Maine. State Republican lawmakers have used a federal audit that found $46 million in potentially improper payments as an example of fraud, although no intentional misuse was suspected. 

DHHS has disputed claims that the agency is not cracking down on fraud, announcing earlier this month that it suspended payments to five providers and terminated two providers’ contracts for subjecting residents to serious health risks and unsafe conditions. In letters obtained by Maine Morning Star, the agency also shared reasons for why each provider is facing suspension or termination.

When the rulemaking petitions were initially announced, the department outlined some actions the Mills administration has taken to increase scrutiny on providers, including requiring licensing standards for all group homes, personal care agencies and certain providers offering behavioral health support. 

With these standards in place, the department has the authority “to exercise stronger oversight and enforcement powers over these providers,” spokesperson Alisa Morton said in June.

Libby said through the petition process, “Maine citizens stepped up to fill that gap” in accountability. 

“We are confident that thousands of Mainers will speak up for common sense accountability rules in the single-largest program in state government,” she added.

The rulemaking process allows for public comment until Sept. 20, and the department will hold a public hearing on the proposed rule on Sept. 10 in Augusta. 

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