Quick ExitThe Attorney General's Healthcare Crimes Unit (the State's designated Medicaid Fraud Control Unit) is a federally-funded unit charged with investigating and prosecuting MaineCare fraud and abuse, neglect or financial exploitation occurring in MaineCare facilities or committed by MaineCare providers or their employees.
The Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $1,643,020 for Federal fiscal year (FY) 2026. The remaining 25 percent, totaling $547,669 for FY 2026, is funded by the State of Maine.
Reporting MaineCare fraud and other healthcare crimes
If you suspect that MaineCare fraud has occurred, or abuse, neglect or exploitation has occurred in a MaineCare facility or by someone working for a MaineCare provider, contact us.
If you are concerned about incapacitated or dependent adults (age 18 and over) in danger of abuse, neglect or exploitation, call the 24-hour Adult Protective Services hotline at the Department of Health and Human Services Adult Protective Services hotline at 1-800-624-8404 or use their online reporting service.
If the incident needs immediate attention, call 911 immediately.
What is fraud?
Healthcare fraud can take a variety of forms. Common examples include:
- Billing for services not rendered or performed
- Dispensing generic drugs and billing for brand name drugs
- Billing for a higher level of service than was actually performed
- Billing for unnecessary services
- Billing using separate billing codes when the services should have been grouped together under one billing code
- Kickbacks
- Double billing
- Denial of necessary services or procedures, or denial of access to specialists
- Embezzlement
What is abuse, neglect, and exploitation?
Abuse
- Unreasonable confinement
- Unnecessary or unsafe restraint
- Sexual abuse
- Emotional or verbal abuse (including harassment, threats, and intimidation)
Neglect
- A caregiver failing to provide care, food, shelter, or clothing.
- A caregiver failing to provide supervision or abandoning the incapacitated or dependent adult.
- Self-neglect - if an incapacitated or dependent adult is unable to care for their own well-being or meet their basic needs due to impairment.
Exploitation
- Financial exploitation, such as wrongfully taking or using the adult’s property or resources
- Financial frauds or scams
- Medication theft
- Sexual exploitation