Overview
- CMS Administrator Dr. Mehmet Oz visited Maine on Monday to review home‑based services for adults with autism and intellectual disabilities and publicly asserted that roughly nine out of ten billed services lacked supporting backup.
- Federal auditors and reporting have previously flagged about $45–46 million in questionable Maine payments for applied behavior analysis and related autism services.
- The Justice Department announced indictments in Pennsylvania as part of a broader anti‑fraud initiative while no criminal charges have been publicly reported in Maine to date.
- Maine Department of Health and Human Services says it takes fraud seriously, is coordinating with CMS and the OIG, and affirms rigorous oversight even as officials have not publicly released case‑level evidence to substantiate the 90 percent claim.
- If investigations continue to find unsupported claims, the next steps could include state and federal audits, civil recoveries and possible prosecutions, and the outcome could change how home‑based disability services are certified, billed and monitored for people who rely on them.