Schmitt Leads Senate Anti-Fraud Task Force in Exposing Massive Medicaid Fraud Scandal in Maine, Launching Oversight Investigation into Potential Medicaid EVV Vulnerabilities

U.S. SENATE — Today, U.S. Senator Eric Schmitt (R-MO), joined by Senators Roger Marshall (R-KS), Ashley Moody (R-FL), Pete Ricketts (R-NE), and Tommy Tuberville (R-AL), sent oversight and document preservation letters to Sandata Technologies/HHAeXchange and Gainwell Technologies regarding potential vulnerabilities in Electronic Visit Verification (EVV) systems used to verify Medicaid services. The letters seek information related to whistleblower allegations that EVV records may be susceptible to post-service modifications and request extensive documentation to determine whether existing safeguards adequately protect taxpayer dollars before Medicaid claims are paid. The senators wrote, “Electronic Visit Verification was established to ensure Medicaid only pays for services that were actually provided to eligible beneficiaries by authorized caregivers at the correct time and location. When implemented correctly, EVV serves as an important safeguard against fraud, waste, and abuse. But if weaknesses in these systems allow visit records to be altered after the fact without meaningful transparency or oversight, taxpayers deserve answers.” “The Senate Anti-Fraud Task Force has received whistleblower information raising serious questions about whether audit trails, GPS location data, and other critical verification records are consistently preserved, accessible, and used during the claims review process. Our oversight seeks to determine whether federal and state partners have the tools necessary to identify improper payments before taxpayer dollars leave the door,” the senators continued. In the letters, the senators request: Immediate preservation of documents, communications, audit trails, databases, GPS and geolocation records, and electronically stored information related to MaineCare’s EVV program dating back to January 1, 2021. Detailed information regarding Sandata’s audit logs, manual edit capabilities, GPS and location verification data, provider-level edit rates, fraud detection processes, and contracts supporting MaineCare’s EVV system. Comprehensive information from Gainwell Technologies regarding how EVV records are matched to MaineCare claims, what audit information is available during claims adjudication, and whether claims processors can identify manually modified records or location anomalies before payments are issued. Technical documentation, provider-level reports, and claims data necessary to evaluate whether existing verification systems effectively detect fraud, prevent improper payments, and safeguard taxpayer-funded Medicaid programs. Information that will help determine whether similar oversight concerns exist in other states utilizing Sandata or comparable Electronic Visit Verification systems. “Congress has a responsibility to ensure that taxpayer dollars are spent as intended and that the systems designed to prevent fraud are actually working,” the senators concluded. “These letters are an important first step in determining whether current safeguards are sufficient, identifying potential vulnerabilities, and ensuring federal Medicaid dollars are protected through transparent, accountable oversight.” Read the letter sent to Sandata Technologies HERE. Read the letter sent to Gainwell Technologies HERE. Last month, Schmitt launched the Senate Anti-Fraud Task Force with a group of his Republican colleagues to identify fraud, strengthen oversight, and protect taxpayer dollars through aggressive investigations, legislative reforms, and coordinated enforcement efforts. ###