Maine Gov. Janet Mills on Monday accused the Trump administration of using fraud allegations as a “pretense” for enhanced immigration enforcement after a top federal health official criticized the state’s Medicaid program and demanded answers from the governor.

Mills’ response came after Dr. Mehmet Oz, administrator for the U.S. Centers for Medicare and Medicaid Services, posted a video statement on Friday in which he referred to Medicaid fraud accusations in Minnesota and said “the same thing appears to be happening in Maine.”

“Maine also needs to clean up its act,” Oz said in an Instagram post.

The Trump administration has tied the Minnesota Medicaid accusations to the state’s Somali American population, and officials — including President Donald Trump — have alleged that similar misconduct is occurring in Maine.

Oz also said he had sent a letter to the Mills administration requesting information about what state officials are doing to identify and prevent fraud. Oz said he had given Maine leaders 30 days to respond, and “if we’re not satisfied with their answers, CMS is ready to take action.”

Oz, in the video, cited a January U.S. Office of Inspector General report that outlined $45 million in potential improper payments for autism support services in Maine’s Medicaid program.

“One hundred percent of the claims (federal investigators) examined had problems,” Oz said. “And most troublingly of all, they discovered that Maine had never conducted a statewide review of its autism program.”

When the Inspector General’s report was released in January, Maine Department of Health and Human Services officials said the report “does not include findings or allegations of fraud” but instead highlighted “potential documentation and compliance issues,” which the state is reviewing.

The report does not accuse “intentional wrongdoing” by Maine’s Medicaid providers or the state, Maine DHHS said.

Mills, in a statement Monday, accused Oz and the Trump administration of a “political attack.”

“Let’s be clear about what this is: Maine is facing a political attack from a president who uses allegations of fraud as a pretense to send (U.S. Immigration and Customs Enforcement) and other weaponized federal agents into states led by Democrats with devastating consequences,” Mills wrote. “This is part of President Trump’s malicious playbook of using his administration’s power to punish anyone who dares to stand up to him or who disagrees with him.”

Federal immigration officials conducted stepped-up immigration enforcement across Maine in late January, but that effort has apparently been pared back. U.S. Sen. Susan Collins said she was told that the enhanced operation — which the administration dubbed “Operation Catch of the Day” — had concluded. Maine groups tracking immigration enforcement say the surge appears to have ended but that arrests are still happening.

Mills, citing her past roles as a district attorney and Maine attorney general, said she will hold anyone who engages in fraud accountable, but said the Trump administration is focused on political retribution.

“Maine will not be intimidated by an administration whose clear goal is to weaponize its power against the American people and to punish anyone who stands up to them,” she said. 

However, Maine Republican Senate Minority Leader Trey Stewart said Oz’s letter is a “basic request for information.”

“Governor Mills has allowed misuse of taxpayer funds to permeate through the MaineCare program through a lack of accountability and leadership,” Stewart said in a statement Monday.

Maine House Republicans announced Monday that they would hold a news conference on the matter at the State House in Augusta on Tuesday.

DHHS Commissioner Sara Gagne-Holmes said in a statement that the agency “takes seriously its responsibility to serve as a responsible steward of taxpayer money by effectively disbursing funding and closely monitoring and ensuring compliance with the programs under its purview.” 

Oz, in Friday’s letter, presented Maine with numerous questions about state oversight of various Medicaid services that state officials must answer within 30 days. The letter also highlighted services where overbilling may have occurred.

“Behavioral health services present significant concerns, with more than $21 million flagged by CMS’ Fraud Prevention System based on unusual billing patterns,” Oz wrote in the letter. “These services were concentrated in psychosocial rehabilitation, wraparound services, day treatment and community support.”

The January Inspector General’s report “found numerous instances of missing, incomplete or contradictory documentation in violation of federal and state requirements,” Oz said in the letter.

In their January response to the report, Maine DHHS officials said reasons for the spike in costs included higher Medicaid enrollment, “Maine’s efforts to increase the availability of behavioral health services,” rising reimbursement rates and increased usage of health services.

Those factors “resulted in increased costs, but also served the health care needs of Maine patients and their families,” the department said.

Meanwhile, in December, Maine DHHS suspended Medicaid payments to Portland nonprofit Gateway Community Services after an audit discovered $1.1 million in overpayments in 2021 and 2022. State officials said then that the suspension was due to a “credible allegation of fraud” against Gateway.

Gateway officials have denied any wrongdoing and said they are cooperating with a state investigation.