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Did You Miss This Story About Alleged Medicaid Fraud From a Somali-Run Health Services Provider in Maine?

Did You Miss This Story About Alleged Medicaid Fraud From a Somali-Run Health Services Provider in Maine?
Photo: Business Wire

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. 

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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). 

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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. 

Maine Republicans recently warned that this scheme is just the tip of the iceberg

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These fraud schemes dashed Tim Walz’s hopes of a third term as governor of Minnesota. Could it derail Mills’ attempt to win a Senate seat?

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