Goodwill Industries of Northern New England
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $1,983.94 per claim for T2016 (Habilitation, residential, waiver; per diem), which is 6.0× the national median of $331.94.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Total Paid
$106.0M
$106,024,243
Total Claims
313K
Beneficiaries
51K
6.1 claims/patient
Avg Cost/Claim
$339
🔍 Analysis
Provider Overview
Goodwill Industries of Northern New England is a Clinic/Center Rehabilitation Comprehensive Outpatient Rehabilitation Facility (CORF) provider based in Portland, ME. From the 2018–2024 period, this provider received $106.0M in Medicaid payments across 313K claims.
Why This Matters
This provider received $106.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 13,253 Medicaid beneficiaries for a full year at average per-enrollee costs.
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