AUGUSTA — A federal health care watchdog has again found fault with Maine’s treatment of people with acute mental illness at the Riverview Psychiatric Center, ordering that the state repay $51 million in federal aid.

Gov. Paul LePage announced Thursday that the state will appeal the decision, calling it a “financial tsunami.”

At issue is the decertification of Riverview by the federal Center for Medicare and Medicaid Services in 2013. According to LePage, the federal government has notified the state that it is “disallowing” $51 million that has been drawn down for the state-run hospital in Augusta.

LePage said in a written statement that he has warned the Legislature to stop using the federal funding.

“Our administration has clearly communicated on numerous occasions that continuing to use [federal] funding posed a significant risk of disallowance,” LePage said. “Our administration warned the Legislature over and over that action needed to be taken and those warnings were ignored. Now we are faced with a financial tsunami.”

LePage said he expects the Legislature to allocate $51 million to cover the cost of the federal action.

According to a June 7 letter to the Maine Department of Health and Human Services from the Centers for Medicare and Medicaid Services, the federal government is essentially recalling funding that has flowed to Riverview from Dec. 31, 2013, through March 31 of this year. The state can either repay the money now or keep it during the appeals process, though if the final decision goes against Maine, the state would be liable for the $51 million plus interest.

Riverview’s decertification resulted from a number of factors, including overcrowding, inadequate staffing and the use of tasers and corrections officers in portions of the hospital.

The state has been working on gaining recertification for Riverview but so far has not succeeded, The matter went to court in 2015, but a U.S. District Court judge ruled against Maine in its bid to overturn the termination of accreditation. According to CMS, the period for appealing that court decision expired in October 2015.

As part of its efforts to regain certification, the LePage administration has been pushing to create a separate, privately run forensic psychiatric unit for patients found not responsible for various crimes because of mental defects.

That issue caused controversy in December 2016 when lawmakers, mostly Democrats, demanded that the proposal to build the facility in Augusta be subject to legislative review. The LePage administration, in response, switched the proposed location to Bangor. The state is still in the process of moving forward with that project. Last month, the state issued a request for qualifications for a developer, contractor and design teams to build the 8,300-square-foot facility at 159 Hogan Road in Bangor.

Former Maine DHHS Commissioner Mary Mayhew, who resigned from her position earlier this month to launch a gubernatorial run, wrote in a December 2015 column in the Bangor Daily News that the administration had tried and failed on numerous occasions to work with the Legislature to fix the problems.

“Addressing treatment planning and staffing is essential and we have made significant progress,” wrote Mayhew. “But until Maine has a solution for securely housing and treating violent mentally ill, Riverview’s recertification — and far more importantly its patients and staff — will remain at risk.”

According to the June 7 letter from CMS Associate Regional Administrator Richard R. McGreal, Maine has 60 days to appeal his decision, which he referred to more than once as “final.”

“If the final decision [on appeal] upholds the disallowance and the state elected to retain the funds during the appeals process, the proper amount of the disallowance plus interested … will be offset in the subsequent grant award,” McGreal wrote.

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