Former Employee Claims Massive Somali Medicaid Fraud Scheme going on in Maine

When it comes to allegations of fraud involving Medicaid-funded organizations, Minnesota may not be the only state facing scrutiny.

A former employee of an organization that partners with the state of Maine has come forward as a whistleblower, alleging that a large-scale Medicaid billing scheme may be operating there as well.

Lewiston, Maine—like Minneapolis—has been a longtime destination for Somali migrants. The similarities between the two cases have prompted renewed calls for oversight and further investigation.

According to reporting by NewsNation, a Maine-based health services contractor is disputing fraud allegations raised by a former employee, even as internal records appear to contradict the organization’s public defense.

Gateway Community Services, a Somali American–led nonprofit that contracts with the state, issued a statement denying the claims. “These allegations are false,” the organization said, adding that it maintains strict billing and compliance standards and has cooperated with state oversight agencies. Gateway also stated that the whistleblower, Christopher Bernardini, never raised concerns about billing or fraud during his seven years with the organization.

However, records reviewed by NewsNation show that Bernardini’s supervisor documented instances in which he flagged questionable billing practices.

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Whistleblower details massive Somali fraud scheme in Mainepic.twitter.com/xXWEycNmiL

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Bernardini alleges that Gateway submitted false documentation for client visits and billed Medicaid for services that were never provided. He told NewsNation that clients later contacted the organization confused about hours they were supposedly responsible for, despite not receiving the services listed. When asked whether he believed what he witnessed constituted fraud, Bernardini said he had no doubt.

Local station WMTW reports that the allegations have drawn attention from both state and national Republican lawmakers, who are calling for investigations into immigrant-focused organizations that receive federal Medicaid funding.

The station also reported that Gateway Community Services is scheduled to be included in a state audit this year. Documents obtained by WMTW show that between 2015 and 2018, Maine overpaid the nonprofit more than $662,000, according to the Department of Health and Human Services. The agency said the overpayment was identified through two multi-year audits examining tens of thousands of billing claims across multiple service categories.

A separate audit completed in 2024 is currently under appeal. DHHS stated that all of the audits were initiated following complaints.

Taken together, the allegations and audit findings suggest the issue may be broader than has been widely reported, reinforcing calls for continued investigation and transparency.

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