Published: August 26, 2026
Publisher: The Maine Mirror
The Maine Mirror Accountability Series — Article 1 of 7

Primary-source records obtained by The Maine Mirror through Maine’s Freedom of Access Act document what happened after federal auditors estimated at least $45.6 million in improper Medicaid payments involving services for children diagnosed with autism. The records show CMS identified four findings requiring corrective-action updates, gave Maine 30 days to respond, and received four corrective-action plans from the state.

When federal auditors reported in January that Maine had made an estimated $45.6 million in improper Medicaid payments for rehabilitative and community support services provided to children diagnosed with autism, the number understandably became the headline.

But publication of the audit did not end the federal process.

Records independently obtained by The Maine Mirror through a Freedom of Access Act request document what happened in the weeks that followed. The Centers for Medicare & Medicaid Services reviewed the audit, formally sought additional information from Maine, identified four findings requiring corrective-action updates and gave the state 30 days to respond.

Maine responded with four corrective-action plans.

Those records provide a clearer picture of what happened after the audit became public, what Maine agreed with, what it questioned and what the state told federal officials it intended to do next.

About These Records

The documents examined in this report were obtained directly from the Maine Department of Health and Human Services through a Freedom of Access Act request submitted by The Maine Mirror.

The production includes correspondence between Maine DHHS and the Centers for Medicare & Medicaid Services, Maine’s formal response to the federal audit and detailed corrective-action plans addressing the audit findings.

Screenshots of those records are reproduced throughout this article so readers can examine the underlying source material alongside The Maine Mirror’s reporting.

CMS Formally Followed Up With Maine

On February 2, 2026, CMS’s Financial Management Group sent a formal Request for Information to Maine State Medicaid Director Michelle Probert concerning OIG Audit A-01-24-00006.

The subject identified the audit directly: Maine Made at Least $45.6 Million in Improper Fee-for-Service Medicaid Payments for Rehabilitative and Community Support Services Provided to Children Diagnosed with Autism.

CMS wrote that it had reviewed the January 16 audit, along with Maine’s responses and corrective-action plans referenced in the report.

The federal agency also made its objective clear: it wanted the identified instances of noncompliance resolved and closed and said it would actively work with Maine toward that goal.

( A February 2, 2026, letter from the Centers for Medicare & Medicaid Services to Maine State Medicaid Director Michelle Probert formally opens a Request for Information concerning OIG Audit A-01-24-00006. CMS states that it reviewed the audit and would work with Maine to resolve and close the identified instances of noncompliance. Source: CMS record obtained by The Maine Mirror through a Freedom of Access Act request.)

The letter marked an important transition. The question was no longer only what federal auditors had found, but what Maine would be required to do about those findings.

CMS Identified Four Findings Requiring Corrective-Action Updates

The following morning, CMS made that expectation more explicit.

In a February 3 email to Probert, Sharla Broughton of CMS’s Audit and Review Branch wrote that CMS had received the OIG audit and conducted an initial review.

According to CMS, that review identified four audit findings requiring corrective-action updates from Maine in order to resolve and close the findings.

CMS directed Maine to begin reviewing the findings, prepare updates to its corrective actions and respond within 30 days, regardless of whether the state had updates to provide.

(A February 3, 2026, email from CMS’s Audit and Review Branch to MaineCare Director Michelle Probert states that CMS’s initial review identified four audit findings requiring corrective-action updates from Maine in order to resolve and close the findings. CMS directed Maine to respond within 30 days. Source: CMS-DHHS correspondence obtained by The Maine Mirror through a Freedom of Access Act request.)

The significance of that communication is straightforward: publication of the audit did not close the matter. CMS was requiring additional action from Maine.

What Were the Four Findings?

The four findings extended beyond the $45.6 million figure.

The first concerned an estimated $45.6 million in improper payments, including approximately $28.7 million representing the federal share. OIG recommended that Maine refund $28,796,366 to the federal government.

The second concerned an additional estimated $22.4 million in potentially improper payments, including approximately $14.2 million in federal funds. The finding also raised concerns that cloned or otherwise unreliable session notes could indicate that children with autism may not have received the type of RCS services they needed.

The third concerned Maine’s oversight of RCS payments and called for additional provider guidance regarding documentation, session notes, billable service time and signature requirements.

The fourth addressed a longer-running oversight issue: Maine had not conducted a statewide post-payment review of RCS providers to verify compliance with documentation and claim requirements since the program began in 2010.

CMS sought additional information and documentation from Maine addressing all four.

Maine Responded With Four Corrective-Action Plans

On March 4, Maine submitted its formal response.

In a letter to CMS Deputy Director Jennifer Clark, DHHS stated that its response included corrective-action plans addressing each recommendation.

Maine also used the response to explain where it believed additional context was necessary.

DHHS emphasized that the audit was not triggered by a specific allegation of misconduct and that OIG’s report did not contain findings or allegations of fraud or intentional wrongdoing. The state said the report instead identified potential documentation and compliance issues, including missing provider signatures on otherwise complete treatment plans.

At the same time, Maine told CMS that its Program Integrity process was reviewing the providers and services identified in the audit.

DHHS said determinations regarding violations, sanctions and recoveries would be made under applicable state and federal requirements. Where the state ultimately identified overpayments, it said it would refund the applicable federal share.

(Maine DHHS’s March 4, 2026, formal response to CMS states that corrective-action plans addressing each audit recommendation were enclosed. DHHS also says MaineCare’s Program Integrity process was reviewing the providers and services identified in the audit and that violations, sanctions and recoveries would be determined under applicable state and federal requirements. Source: Maine DHHS record obtained by The Maine Mirror through a Freedom of Access Act request.)

The response shows a more complicated position than either complete acceptance or outright rejection of the audit. Maine entered the corrective-action process while continuing to question portions of the federal findings and how some of the estimated overpayments were calculated.

Maine “Partially Agreed” With the $45.6 Million Finding

The first corrective-action plan provides the clearest example.

At the top of the document is OIG’s finding that Maine made an estimated $45.6 million in improper payments, including approximately $28.7 million in federal funds.

Directly beneath it appears the recommendation that Maine refund $28,796,366 to the federal government.

Maine’s official position appears immediately below:

“PARTIALLY AGREE.”

DHHS said it agreed that OIG’s improper-payment findings warranted review of providers’ claims and associated documentation.

But Maine said it had not yet had sufficient time to determine the degree to which it agreed with OIG’s identified overpayments, whether those overpayments represented the appropriate sanctions under Maine rules, or whether OIG’s statistical extrapolation methodology was valid.

Maine therefore committed to conducting its own review.

If those reviews identified violations, Program Integrity would determine appropriate sanctions. If they identified overpayments, DHHS said it would recover those funds from providers and refund the applicable federal share.

The Corrective Plan Included Debt Notices, Recoveries and Deadlines

The corrective-action plan went beyond a general promise to review the issue.

It established four specific steps.

Step 1: MaineCare’s Program Integrity Unit would review OIG’s findings and associated provider medical records to determine whether violations occurred, with an estimated completion date of April 30, 2026.

Step 2: Program Integrity would issue Notices of Violation and Notices of Debt to providers determined to owe recoupments for OIG findings confirmed by the unit. The estimated completion date was June 30, 2026.

Step 3: Maine DHHS would refund the federal share of Program Integrity-confirmed improper payments, with a listed completion date of September 30, 2026.

Step 4: Maine would provide CMS with a final report detailing the results of Program Integrity’s review and the dates of federal-share repayments for confirmed improper payments. That deadline was October 30, 2026.

(Maine’s detailed corrective-action plan for the first audit finding shows the estimated $45.6 million in improper payments and OIG’s recommended $28,796,366 federal refund alongside Maine’s official position of “PARTIALLY AGREE.” The plan establishes four corrective steps, including Program Integrity review of provider medical records, potential Notices of Violation and Notices of Debt, repayment of the federal share of confirmed improper payments, and a final report to CMS. The listed deadlines run from April 30 through October 30, 2026. Source: Maine DHHS corrective-action plan obtained by The Maine Mirror through a Freedom of Access Act request.)

The document puts substance behind the phrase “corrective action.”

For the first finding, Maine committed to examining underlying provider records, determining whether violations occurred, potentially issuing violation and debt notices, recovering confirmed overpayments, returning the applicable federal share and reporting the final results to CMS.

As of this article’s August 26 publication, the April 30 and June 30 dates have passed.

That does not establish that Maine failed to complete either step.

The records produced through this particular FOAA request do not establish the results of those steps or whether they were completed on schedule. They do, however, establish specific benchmarks against which subsequent records can be measured.

The Other Three Corrective-Action Plans

Maine submitted a separate corrective-action plan for each of the remaining findings.

For the second finding, Maine agreed that the potentially improper-payment findings warranted review. Its plan again called for Program Integrity to review providers and claims, determine whether violations occurred, impose appropriate sanctions where warranted, recover confirmed overpayments and refund the applicable federal share.

For the third, Maine agreed additional provider guidance was necessary. Its response included mandatory provider training and changes to the rules governing Section 28 services.

For the fourth, Maine agreed with the finding concerning the absence of statewide post-payment reviews since the program began in 2010.

The corrective-action plan committed Program Integrity to reviewing 30 Section 28 providers each year until all Section 28 RCS providers have undergone a post-payment review, with completion projected for state fiscal year 2029.

Each of those findings presents a separate accountability question, and each will be examined more closely as this series continues.

Maine Submitted the Plans on the Day They Were Due

The email correspondence obtained by The Maine Mirror completes this portion of the timeline.

At 4:54 p.m. on March 4, Probert emailed CMS with Maine’s corrective-action plan and accompanying cover letter attached.

Minutes later, she forwarded the response to another CMS official after receiving an out-of-office reply. Probert explained that she wanted to make sure someone at CMS’s Financial Management Group received Maine’s response, which she noted “is due today.”

On March 10, CMS acknowledged receiving the submission.

Broughton thanked Maine for its response and said she would review it and follow up with the state’s team if questions remained.

(Internal correspondence documents Maine’s March 4, 2026, submission of its corrective-action plan to CMS on the day the response was due. On March 10, CMS’s Audit and Review Branch acknowledged Maine’s response and stated that it would review the submission and follow up with the state if questions remained. Source: CMS-DHHS correspondence obtained by The Maine Mirror through a Freedom of Access Act request.)

Taken together, the records establish that CMS required corrective-action updates, Maine submitted four corrective-action plans detailing its proposed response, and CMS received the submission for review.

The records in this production do not, however, establish CMS’s ultimate determination following that review.

That distinction is important, particularly as later deadlines in Maine’s plans approach.

The $45.6 Million Audit Was the Beginning, Not the End

The $45.6 million figure deserved attention, but the records obtained by The Maine Mirror show that publication of the audit was only the beginning of the federal-state process that followed.

CMS required additional action. Maine responded with four corrective-action plans. Those plans contemplated provider and medical-record reviews, potential Notices of Violation and Notices of Debt, recovery of confirmed overpayments, changes to provider oversight and specific deadlines for reporting results back to the federal government.

The records also lead directly to another question—one central to how the original audit has been understood:

Does Maine actually owe the federal government $28.8 million?

OIG recommended that Maine refund $28,796,366 in federal funds associated with the estimated $45.6 million in improper payments.

But Maine did not simply accept that amount.

Its official response was “PARTIALLY AGREE.”

DHHS said it still needed to determine the extent to which it agreed with OIG’s identified overpayments, whether the amounts represented appropriate sanctions under state rules and whether OIG’s statistical extrapolation methodology was valid.

Maine instead committed to conducting its own Program Integrity review and refunding the federal share of overpayments that review ultimately confirmed.

The distinction is significant.

OIG recommended $28.8 million be returned. Maine committed to returning the federal share of confirmed improper payments. The records examined for this report do not establish that those figures will ultimately be the same.

CMS’s correspondence adds another layer. The agency described requirements governing adjustments and refunds and said that if an outstanding refund were not received within applicable federal time limits, CMS could initiate a disallowance to obtain the recommended refund amount, subject to reconsideration and appeal procedures available to Maine.

That is where this series goes next.

Next in The Maine Mirror Accountability Series — Article 2 of 7

Does Maine Actually Owe the Federal Government $28.8 Million?

The headline number is clear. The primary-source record behind it is considerably more complicated.

Article 2 will follow the money: what OIG actually recommended Maine repay, what CMS subsequently required, why Maine only partially agreed, what the state committed to repay instead, and what would have to happen before the final amount is known.

Article 2 of 7 continues tomorrow.

Transparency Note

The Maine Mirror uses artificial intelligence as an editorial-assistance tool in researching, organizing and drafting coverage. Reporting decisions, source review, verification and publication decisions remain the responsibility of The Maine Mirror.

The primary-source documents cited and reproduced in this article were obtained directly from the Maine Department of Health and Human Services through a Freedom of Access Act request. AI-generated material is not used as primary-source evidence.

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