Did You Miss This Story About Alleged Medicaid Fraud From a Somali-Run Health Services Provider in Maine?
The story is a bit old, but
given that state fraud is now under the microscope, here’s a tale
NewsNation did from Maine. It’s not about Somali daycare centers, but a
Somali-run health services contractor, and the allegations are just as
severe. It could complicate Maine’s Senate race, as Gov. Janet Mills,
who is running to usurp Republican incumbent Sen. Susan Collins, might
be wrapped up in it.
Christopher Bernardini was the billing master for Gateway Community
Services, who he claims is part of a scheme that defrauds taxpayers out
of millions. He’s coming forward to expose the truth. Sordid tales of
fake file claims and services billed but never carried out are pervasive
with this story, which first aired last December. This scheme turned
into a free-for-all during the COVID pandemic (via NewsNation):
The
whistleblower, Christopher Bernardini, describes himself as a former
“billing guru” of Gateway Community Services — a health services
contractor that he says defrauded Maine’s Medicaid program. Bernardini
worked for Gateway from May 2018 until April 2025 as a program
coordinator.
Bernardini alleges that Gateway oversaw a system in
which false records were filed about client visits. He alleges an
electronic monitoring system designed to track movements was manipulated
to make it seem like field staff were visiting low income and disabled
clients, when in reality they did not come within miles of the clients’
homes.
They then charged taxpayers for providing services that were never performed, according to Bernardini.
“I
just couldn’t fathom it — I thought we were helping people; I thought
this was all on the up-and-up,” Bernardini tells NewsNation in an
exclusive interview. “I have a passion for helping people and I thought
that we were doing the right thing this whole time.”
Bernardini
says he grew disillusioned “when I saw how they were swindling people.
When I had clients calling me to tell me their staff hadn’t shown up and
I was told to bill those hours anyway. It just got worse and worse
until I started really putting up a stink.”
[…]
“I
demanded a full investigation when I heard initial reporting about this
welfare fraud scandal last May,” state Senator Matt Harrington (R) told
NewsNation.
He criticized Democratic Gov. Janet Mills’ administration over the issue.
“The
Mills Administration has neglected obvious and credible reports of
Somali-linked systemic fraud in the MaineCare system,” Harrington said.
“This is an outrageous betrayal of Maine taxpayers.”
[…]
On
March 22, 2022, Gateway received a notice of violation from the state’s
MaineCare Services Program Integrity Unit. Based on a review of
Gateway’s records and billing during 2017 and 2018, the unit estimated
that MaineCare made overpayments totaling $904,000, although the amount
was later revised to $776,000.
The state notice included a
number of reasons for why it felt it had overpaid Gateway, including
documentation for interpretative services not having matching start and
stop times, and no signature dates.
Bernardini alleges that the
questionable activity and billing practices grew exponentially during
the COVID pandemic, when the federal government handed out close to $1
trillion as part of the Paycheck Protection Program (PPP).
Of course, the director of the state’s Medicaid program denied
the fraud allegations, adding that Mr. Bernardini never flagged any
discrepancies, though records proved otherwise. The outlet cited a 2022
performance review of Bernardini, which said, “Chris always identifies
potentially fraudulent EVV claims and billing errors.”
Two Somali-American State Representatives have ties to this organization, and there was another whistleblower:
Two Somali-American state representatives in Maine have had close ties to Gateway.
Democratic state Rep. Deqa Dhalac previously served as executive director of the organization.
Rep.
Yusuf Yusuf wrote in his legislative profile that he worked closely
with Gateway, though that reference was removed from his profile last
week. Neither representative responded to requests for comment.
Second whistleblower files federal HHS complaint supporting claims
Following
Gateway’s public response, a second former employee came forward
anonymously to support Bernardini’s allegations and filed a federal
complaint with the Department of Health and Human Services.
The
Maine Attorney General’s Office said it “is not able to confirm or deny
the existence of any investigation.” Gov. Janet Mills has not responded
to requests for comment.
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