CrimsonPhantom
CUSA Curator
Posts: 62,785
Joined: Mar 2013
Reputation: 3193
I Root For: NM State
Location: |
RE: Maine's Somali Fraud
Somali refugee contractor defrauded Maine Medicaid funds, lied about completing services: whistleblower
Quote:As a renewed focus has been on widespread fraud in Minnesota’s Somali community, reports have come out in Maine regarding the state’s Medicaid program and a health services contractor accused of defrauding it.
Christopher Bernardini, former program coordinator of Gateway Community Services between May 2018 and April 2025, told NewsNation that the organization has defrauded Maine’s Medicaid program. Per Gateway Community Services’ website, the organization "is a trusted resource for immigrant, refugee, and asylee communities across Greater Portland and Lewiston-Auburn," areas with large Somali migrant communities.
Bernardini alleged that Gateway oversaw an electronic monitoring system that was manipulated to make it appear as though field staff had been visiting disabled and low-income clients, when these visits did not take place. The electronic monitoring system is designed to track the movements of staff. Bernardini said that despite the visits not actually taking place, taxpayers were charged for providing the services.
He told NewsNation, "I just couldn’t fathom it — I thought we were helping people; I thought this was all on the up-and-up. I have a passion for helping people and I thought that we were doing the right thing this whole time." He said 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."
Another former Gateway employee who asked to remain anonymous said they witnessed records being manipulated. "I saw many things happening that shouldn’t have been. Timecards being manipulated to show services being provided they were not — and times also being manipulated."
State Senator Matt Harrington (R-York) has demanded that a probe be carried out. "I demanded a full investigation when I heard initial reporting about this welfare fraud scandal last May. He added, "The [Janet] Mills Administration has neglected obvious and credible reports of Somali-linked systemic fraud in the MaineCare system. This is an outrageous betrayal of Maine taxpayers."
MaineCare is Maine’s Medicaid program, which "provides health care coverage for Maine’s children and adults who are elderly, disabled, or with low incomes." Gateway worked with MaineCare.
Gateway’s founder and CEO is Abdullah Ali, a Somali who came to Maine as a refugee. While serving as the organization’s executive director in 2024, he ran for president of the Somali state of Jubaland.
Ali wrote on X in response to reports about fraud at his organization, "I make no apologies for building a successful business in Maine, working hard to earn a living, earning my PhD, giving back to my Maine community, and running for office in Jubaland. I am proud to contribute my hard-earned $ to support my people back home. America is a nation of laws—you cannot change facts by fabricating false stories. I am proud Somali-American." He has since locked down his account.
Per the Maine Wire, Ali had previously boasted about his fundraising efforts for para-military forces in Somalia. "When I was in the U.S., I contributed to the financial support for the Jubaland-Somali army. To help the troops buy weapons, bullets and food."
Gateway came to the attention of state investigators back in 2022, when the organization received a notice of violation from the MaineCare Services Program Integrity Unit, which estimated, based on a review of the organization’s records and billing during 2017 and 2018, that MaineCare had overpaid $904,000, though this was later revised down to $776,000. Among the reasons listed for why the state felt it had overpaid were a lack of signature dates and documentation for interpretive services not having matching start and stop times.
Bernardini said that the questionable billing practices grew during the pandemic, when the federal government issued nearly $1 trillion as part of the Paycheck Protection Program (PPP). "Once the PPP loan stuff started going on, this one really ticked me off because, all of a sudden, I started seeing these staff come aboard. They’d be on board for two or three weeks."
“No hours worked. I’d put in their training hours... I was doing the time cards and I started seeing bonuses, $2,000 bonuses, going to these staff that had only been with us for two weeks. Never worked a shift with a client and yet the PPP loan comes, they’re giving $2,000 away like they’re lollipops at a doctor’s office and I’m like, ‘Where the hell’s my $2,000 bonus, I’ve been here six, seven years.’”
Records obtained through the Freedom of Access Act by the Maine Wire revealed that Gateway received $28.8 million in payments from MaineCare between 2019 and 2024, with $4.1 million being issued in 2024 alone. A total of $693,382 was given to Gateway in April 2022 under PPP.
Bernardini had raised alarm with the Biden administration’s Department of Homeland Security’s Office of the Inspector General in April 2024, requesting whistleblower protections. He wrote, "I work in the billing department for this agency and I have seen several things that are very questionable and could constitute fraud, waste, or even downright theft. I could not (conscionably) continue doing this work wondering if what we are doing is fraudulent. It does not feel right to continue along this path putting my name on all these documents while constantly wondering about the legality of these potential misdeeds by my organization."
The Inspector General replied that the complaint "does not involve DHS programs or operations," and "as a result, DHS is unable to provide assistance with inquiries or complaints that fall outside DHS OIG’s jurisdiction." The Inspector General said that he could "report fraud through the state of Maine.
Bernardini said he sent a tip to the Maine State auditor’s office following the email, and in April 2025, Gateway terminated his contract, saying it was discontinuing the position. Two months later, he received an email from the office of the Maine State Auditor, asking, "have you communicated with any Federal agencies about this issue with Gateway Community Services LLC," such as the FBI or Homeland Security.
Link
|
|
